Homestead_Buchta INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER . . . • . -
Sherri S Hudson Closing Manager
Preparer of the Sale Disclosure Form Tide
501 Main Street Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000 sherrihudsonaieffbosse.com
Ciry,State and ZIP Code Telephone Number E-mail
E:SELLERS)/GRANTOR(S) . - . : - ' ' -
Stephen D Mounts Pamela J Mounts
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document •
JO f 3b t€wtont,Dnly- I0 13(o tttmvnt
Address(Number and Sweet) Address(Number and Street)
FA kars r--e1 46037 Pj'shn-S, .T1 tf'I'OM
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and omp�equired by law,and is prepared in accordance with
"�IC�6r��1^.�1+�-'S.S,"Real Prope Sales Disclosure Act".
Signature fSeller d'1 —, Signature of Seller I
Stenhen D Mounts -7/2S/1 ti Pamela J.Mounts 4(as(1tf'
Printed Name of Seller Sian Date(MM/oD/YYYY) Printed Name of Seller gggqqq��_��_�tt�tt • Date(M.i/OO/YYYn
F.BUYER S GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AL�LIEIS HAT[pryL -_
Jennifer Buchta `- as
s appears on conveyance document Buyer 2-Name as appears on conveyance document
_643 Titan Drive JUL 3 1 2014
Address(Number and Street) Address(Number and Street)
Evansville,IN 47711 �—
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
Y NO CONDITION I YES GO$WE N
ES d ❑ 1.Will thisiproperty be the buyer's primary < (i ❑ 3.Homestea
residence? Provide complete address of primary ❑ 19 4.Solar Energy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
Address(Number and Street) ❑ GI 6.Hydroelectric Power Device ,'I
ary,s alez/PCOde county ❑ NI 7.Geothermal Energy Heating/Cooling Device
❑ 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 ❑ Fl 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
u1 /))r.
•'se see I t •. • more information.
1 o' �
including county: Not available in all counties.)
3 k2
Address(Number and Street)
t Vohs;11-r _, /A/ 4/77/1 Va fide.71,1/1 12 ,?6o —/J'-3 &- .20o -OO A .3y,2 -o.L7
City,State ZIP Code County -
raryproperlownercontactname _ .•s