Homestead_Reyes INDIANA SALES DISCLOSURE FORM SOF 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.creek @ieffbosse.com
Ciry,State,and ZlPCade Telephone Number E-mail
E.SELLERS)/GRANTOR(S) .
Bert E Sullivan
Seller I•Name as appears on conveyance document Seller 2-Name as appears on conveyance document
37Z FA ESA saST en) -Da-
Address Number and Street) Address(Number and Street)
1
EVAu6VOAt kJ X25
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
a ^ cCt B f
Signature i Alec ` Signature Seller
Rprt F Sullivan ��
Printed Name of Seller Sian Da (MM/DDM'YYI Printed Name ofSeller Sian Date(MM/DD/Ynvi
F.BUYER(S)/GRANTEE(S)'-APPLICATION.FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT_APPLY _ ._ -
Buyer E. Reyes yT
Buyo-]prune as appears on conveyance document Buyer 2-Name as appears on r�{ya�d�ment�
) I I L4 e. 01110 6-t g
Addess(Number and Street) Address(Number and Street)
SC Pn\'`tef-o-n IN: `f1 G70 AUG-21 2014
TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY.61B1 R L T
�1 AUDITOR
Y NO CONDITION I YES NO CONDITION
❑ 1.Will this property be the buyer's primary d 3.Homestead
residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System
residence,including county: ❑
S.Wind Power Device
Address(Number and Street) ❑ 6.Hydroelectric Power Device .
❑ 7.Geothermal Energy Heating/Cooling Device
City,State County
Z.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 for more information.
Not available in all counties.)
Address(Number and Street) 2 4,- /a -i7-10(ya do 87,9 °a 8
City,
ZIP Code County L4,-/R -/7 /Joy do° t 90 9 0.1.7
Primary property owner contact name E-mail