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HomeMy WebLinkAboutHomestead_Bradshaw (2) INDIANA SALES DISCLOSURE FORM SDF ID: _ Page 2 D.PREPARER- _ Jamie Perry Closing Department Preparer of the Sales Disclosure Form Title 7820 Eagle Crest Blvd. Ste 201 Regional Title Services, LLC Address(Number and Street) Company Evansville, IN 47715 812-759-5555 iamie.penveregionaltitlellc.com City,State,and ZIP Code Telephone Number E-mail E.SELLERS)/GRANTOR(S) t. Robert Miley Dana Miley Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 6121E6505 6121E650S Address(Number and Street) Address(Number and Street) Fort Branch IN 47648 Fort Branch IN 47648 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and m ete s required by I. ,and is prepared in accordance with 1 6.1.1-5.S,"Real Pro rty Sales Disclosure Act". Signature of Seller Signature of Seller Robert E Miley ' — --- . Dana I Miley Printed Name of Seller Sian Date(MM/DD/YY191 Printed Name of Seller Sian Date(MM/DD/YYYY) Fi BUYER(S)/GRANTEE(S)-APPLICATIONTORPROPERTY.TAX DEDUCTIONS-.IDENTIFY ALL ITEMS-THAT-'APPLY' -: � ,. Christopher L. Bradshaw Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document esEastvi St Address FILED Address(Number r and Sweet) Address(Number and Scree[) Fort Branch, IN 47648 _ Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THH AATAPPLY. YES NO CONDITION I YES NO CONDITION ]NW tyAif Q ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestcra'AB SON COUNTY AUDITOR residence? Provide complete address of primary n 0 4.Solar Ener Beating Conlin tem residence,including county: n s.Wind Pow e e 406 N Hull Street Address(Number and Street) n El 6.Hydroelec P Fort Branch, IN 47648 Gibson ❑ PA 7.Geothermal En QQ11[[HR41�Q/ oling Device City,State ZIP Code County -( '/ /)J ❑ I,7 2.Does the buyer have a homestead in Indiana to be n 8. Is this grope si Atrial rental property? vacated for this residence? If yes,provide ❑ PA 9.Would you like receiv ta ents for this complete address of residence being vacated, property via e ntact information including county: below. % so lGlu¢ttpps.woppO tformation. Not available in all counties.) Address(Number and Street) a(0 1 q i8-3oa-0oo 3b 1-Doe City,State ZIP Code County Primary property owner mntatt name E-mail