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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Karen S.Creek Closing Agent
Preparer of the Sales Disclosure Form Title
501 Main Street,Suite 101 _Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 812-4214000 karen.creek{ofieffbosse.com
City,Swte and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) -.. _ _ - :.'.
Anthony D Hite •
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
97 9c 1,11 &oo S
Address(Number and Street) Address(Number and Street)
Telephone Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Signature of Seller
Anthony D.Hite x 2-19-1/
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller yytr Sian Date(MM/DD/YYYY)
F.BUYER SI/GRANTEE S APPLICATION FOR-PROPERTYTAX DEDUCTIONS-IDENT Af
Stephanie J.Garcia.Hernandez
.. - •s o,•:.non roar mo •• eat Buyer 2-Name as appears on conveyance document
9794 W.800 South FEB 2 4 2014
Address(Number and Street) Address(Number and Street)
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDI
0 ❑ 1.Will this property be the buyer's primary �0 ❑ 3.Homestead
residence? Provide complete address of primary f 0 4.Solar Energy Heating/Cooling System
residence,including county:
474� �• woo ❑ 0 5.Wind Power Device
S
ddress(Number and Street) '/ ❑ 0 6.Hydroelectric Power Device
(/W EN SUE LC, 1„i k9 �CI BSON
State ZIP Code County ❑ 0 7•Geothermal Energy Heating/Cooling Device
Ciry,
❑ m 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ ❑ 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: ,- • t. • ease see I- I - •., - in ormation.
Not available in all counties.)
Address(Number and Street)
— /7- .t/ - Ace • obit 115 -0 )-/
City,State ZIP Code G my
Primary property owner contact name E-mail