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Homestead_Snodgrass • INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER - -- Karen S.Creek Closing Agent Preparer of the Sales Disclosure Form Tide 501 Main Street,Suite 101 Bosse Title Company Address(Number and Street) Company Evansville, IN 47708 812-421-4000 karen.creekc jeffbosse.com City,State,and ZIP Code Telephone Number E-mail E.SELL ERS)/GRANT0HfS) Homer H Critser Seller 1-Nome as appears on conveyance document Seller 2-Name as appears on conveyance document 3794 W 75 S Address(Number and Street) Address(Number and Street) Princeton IN 47670 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and Y .In ;FegV y law,apd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Stg r o( de Signature of Seller Homer H.Critser by Jeffrey A Bosse POA 07/11/14 Printed Name of Seller Sian Date(MH/DD/YrrY) Printed Name of Seller (xv/DO/YrrY) F.BUYERS GRANTEE S -APPLICATION:FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL IT S A AP 9y randen Snod Cass ••) - • .• • conveyance document Buyer 2-Name as appears on conveyancedocq(npp[ nni 3794 W.75 South JVL 16 1°14 Address(Number and Street) Address(Number and Street) Princeton IN 47670 Sicsfaudir- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITI 0 ❑ 1.Will this property be the buyer's primary (12 ,❑/ 3.Homestea residence? Provide complete address of primary U I rl 4.Solar Energy Heating/Cooling System residence,including county: ❑ r-/ 3 74 9 w 75 S L(-�J-�( S.Wind Power Device Address(Number and Street) L.rl❑ 6.Hydroelectric Power Device ,Address A, _...,J. 47b70 Olasaw ❑ 7.Geothermal Energy Hea ting/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 ❑ 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 or more information. Not available in all counties.) Address(Number and Street) 00O 7T n 3 -027 City,State ZIP Code County A� " // _ Me �,..,..-:�_..• ,ome • ail