Homestead_Leible (4) •
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INDIANA SALES DISCLOSURE FORM SDF ID: Page
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 @jef$bosse.com
Ciry,State,and ZIP Code Telephone Number E-mail
IEi f.SECLER(S)/.GRANTORU ,._2. _ - 7 •
, — — - -- --- --. - -- -..
Paul F Doane I inda L Doane
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
906 Chickasaw Drive 906 Chickasaw Drive
Address(Number and Street) Address(Number and Street)
Ft Branch IN 47648 Fl-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 comple a as re µ'red by law,and is prepared in accordance,with .5,"Re , Property Sales Disclosure Act".
Signature of Seller GC��j Signature of Seller 1�(JABt�Y�-
?atria C. Doaane. o'1. 14- i4 L1&da. L. Doane ot1-14-114
Printed Name of Seller Sian Date(MM/DO/Yin) Printed Name of Seller Sion Date(MM/DD/YYn)
iFEtU-YER(Sj'yGftAA'CIE(SffA8Pti1CATIOMEOR+P-,ROP,ERTYtTAX<DEDUCTIONSb.IDENTIF,Y(AL ITEMSITHATAP,RO _ - _ _____ _
Carolyn D. Leible
v..a s appears on conveyance document Buyer 2-Name as appears on conveyance document
Y QSaW "Dr.
Address(Number and Street) Address(Number and Street)
Y FT.-Branch, 1 u Wrt✓(8
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. ID I OF THOSE :HAT `Ptj '.,
YES NO CONDITION I NO CONDITION
1A ❑ 1.Will this property be the buyer's primary CL ❑ 3.Homestead APR 17 2014
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating Cooling System
residence,including county: ❑ S.Wind Power Devic
Address(Number and Street) ❑ TA 6.Hydroelectri31815011443tONTY AUDITOR
❑ fill 7.Geothermal Energy Heating/Cooling Device
City,State zlpeode County
gj ❑ 2.Does the buyer have a homestead in Indiana to be Ill 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including coup below.Please see instructions for more information.
CIO Chtucae&W Not available in all counties.)
Address(Number and Street)
FT. Rro„hc.Yt 113 k-11(a14$ (at bun nt -/9,/8-/a/-6O/. /S4/"-Oa
Ciry,State ZIP Code County
Primary property owner contact name E-mail