Homestead_Fuhs •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
',P5& "I(^I L1 ± Title Production
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
City,State.and ZIP Code Telephone Number E-mail
_E:SEL'IiER(S)/GRANTOR(S),T . . -
Kimberly Sue Bettag Keith Wayne Bryant
Seller I-Name as appears on conveyance document Seller 2-NNameaas a spears on c/a�r-eyance document •
514 Polk Street Cge7/_J_I.�'-k /tea
Address(Number and Street) Address(Number and Streep ,/
Oakland City IN 47660 tni7,5/]� /-mi l"•
Under penalties of perjury,I hereby certify that this Sales Disclosure,to he best of my knowledge and belief,is true,correct
and complete.as required by law,and is prepared in accordance with 64.1� S,, RSeal Prop yySales Diss losure Act".•
Signature of Seller I Signature of Seller ��
Kimberly Sue Bettag Ca d3-/ y Keith Wayne Bryant e061 0C
Printed Name ofSeller Sian Date(MM/OD/YYYY) Printed Name ofSeller Sign Date DO/DD/Wm)
'F.BUYER(S)/GRANTEE(Sin Ae PL•ICATIONFORPROPERTYTAXDEDUETIONS F.IDENTIFY.ALL,ITEMS.THATAPPLY_ __-
David A. Fuhs
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
3251 Springfield Rd.
Address(Number and Street) Address(Number and Street)
Wadesville, IN 47638
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOS AT yyyyyy PP '. f' J)
YES NO CONDITION I YES NO CONDITION 1 ---/
❑ Q.Will this property be the buyer's primary 7- ❑ c omestead
residence? Provide complete address of primary ❑ Erk..4:Solar Energy HeatJ{int,Cti%l41 em
To S S res'd (;e,in lu county:
❑ D(`57Wind Power Device
rtsess(Number and Street) � y,�_ Irj �; ❑ -6:Hydroelectric Po ev.
�rGllti�'1�� l ` [ ❑ Q'C-Geothermglig i4ce
City,State ZIP Code County
r ❑ (2..Does the buyer have a homestead in Indiana to be ❑ ❑g s this property a residential rental property?
vacated for this residence? If yes,provide n d 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
ncludipg coup �: ' below.Please see instructions for more information.
3?S1 S '
J Not available in all counties.)
Ad •e State mberonl Te`J� ` ^� PtEirS A , O IBS- I3 -I q -90a-coo .034 at5
City,State ZIP Code V ( U intyy p
Primary property owner contact name E-mail