HomeMy WebLinkAboutHomestead_Brusie INDIANA SALES DISCLOSURE FORM SDF ID: . Page 2
D.PREPARER_ .
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number E-mail•
E.SELLER(S)/GRANTOR(S)�-,-- - -. _ .. -_- _._- - --- _ __- -- -- _ _._ _ __ _
Jeff Vincent Charity Vincent
Seller 1-Name as appears on conveyance document II I Seller 2-Name as appears on conveyance document ,,/ /
11168 W 1000 S 4jS hi M1Cr-1 1 i•:-1 11168 W 1000 S 7725-4Z-Z��i/2-G t5—C-
Address(Number and Street) II Address(Number and Street) //'//,/ 1/ `'/' // //
Poseyville IN 47633 ,�`v J �j�-I3 �`( 4)-y? Poseyville IN 47633 / 774,/! 'e�1��"y"��% 77
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 t�1-5.5,"Real P operty Sales Disclosure Act".
yr(ic ) -1 -./� affil-1/!/ !/ �+�G�oC-%cure of Seller 1 1 Signature of5ell�- f
Jeff Vincent `I I lv Charity Vin M c I to( (4
Printed Name of Seller Sian Date OW/DD/TIT) Printed Name ofSeller Sian Date POWDO/In)
Ft BUYER(S)/GRANTEE(S)=.APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY _ .___ _-
Nicholas F. Brusie
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
9645 Caves Dr.
Address(.Number and Street) Address(Number and Street)
Evansville, IN 47725
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY IDFnriry• r.c r•nSF.THAT APPLY.
YES NO CONDITION /TES NO CONDITION SE' P014
0 ❑ 1.Will this property be the buyer's primary 15I II 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy !1,�frSystem
residence,including county:
11168 W 1000 S ❑ 0 5.Windetatt'DA S11NTY AUDITOR
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Posevville. IN 47633 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El 1511 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 ❑ 12 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)
01l04 7-3a -I00 --0ocL.3 /o -od I
City Stare ZIP Code County
Primary property owner contact name E-mail