HomeMy WebLinkAboutHomestead_Lewis (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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 812-421-4000 karen.creek(Dieffbosse.com
City,State and ZIP Code Telephone Number E-mail
E.SEISER(S)%GRAN TOR(S)__--
Patricia J Singer Personal Reo Fstate of Jennifer Klenck
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
5333 •\ci Th P4 :-t" ` —
xAddress(Number and Street) Address(Numberand Street)
r. Ev., M < v; a e— , rld '$ 7111
'
Under penalties of perjury,l hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and mplete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
_ 0•
Signature of Seller 0 Signature of Seller
Patricia J Singer Personal Representative 03/07/14
Printed Name of Seller Sian Date(MM/OD/Mg Printed Name of Seller Sign Date(MM/OP/YYn)
F>BUYER(S)''/.GRANTEE(S-),APPEICATION;EORPROP,ERTirfAX.DEDUETIONS dDENTIFY'ALLITEMSTHAT'APPEV - ,
Jessica J.Lewis
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
• 105 •r■ . l ,. -..LJ -1-. FILED
ddress Number and Street) Address(Number and Street)
�/ lfiricennes , TN (4�t4
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TIIIS PROPERTY. IDENTIFY ALL OF THOSE THAIIAPPLY.T,/l?
YES NO CONDITION I YES NO CONDITION r(BSON,.,��IV7Y.„'l
61 ❑ 1.Will this property be the buyer's primary NI ❑ 3.Homestead OR
residence? Provide complete address of primary ❑ TA 4.Solar Energy Heating/Cooling System
residence,including county: ❑
A ti a S u) 4o 5 5.Wind Power Device -
lddress(Number and Street) ❑ 0 6.Hydroelectric Power Device
i t ^ Ufa q, R. Citron ❑
0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0". 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ g 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: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) o3 6, -//'3 5 .3 0 0 co /. //V 0022
City,State ZIP Code County
Primary property owner contact name E-mail