Homestead_Bradshaw INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER _ _ _ _.. -
Stacey Salzman Closing Officer
Preparer of the Sales Disclosure Form Title
4962 Lincoln AVe First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 812-490-8485 theteam(ahfirstadvantagetitle.com
City,State,and ZIP Code Telephone Number E-mail
I inda Lou Haubold
Seller l-Nmea ppea anveyance docume Seller 2-Name as appears on conveyance document
esN � titie '
ess(Number and Street) Address(Number and Street)
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,
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a comp a as required by law,and is prepared in accordance with IC 6-1.1.5.5,"Real Property Sales Disclosure Act".
14/A-)
a re of Seller Signature of Seller
1 inda I no Hauhnld 9/30/14
Printed Name of Seller Sign Date(101/0D/MT) Printed Name of Seller _ n Date(MMD/
(DYYYY)
F:BUYERj/GRANTEE[S) APPLICATION-FOR.PROPERTY-TAX-DEDUCTIONS=:IDENTIFY:ALL'/ T T.A Ply' . " , - -
a ev L. Bradshaw
o veyance document Tom; I Buyer 2-Name as appears an conveyance document
: 60 War-nc�lc � (' CA OCT 15 2014
sire's(Number and Street) £V Address(Number and Street)
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 ...ISO CONDITION
0 ❑ 1.Will this property be the buyer's primary �❑ 3. Homestead J
residence? Provide complete address of primary LJ ii 4.Solar Energy Heating/Cooling System
residence,including county:
506 Norht Main 111 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Patoka, IN 47666 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 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 ❑ 0 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.
of Oval a. el . ..
Address(Number and Street) aa
City,State ZIP Code County 1 ,16 -0 it_ x t - 3 oak — COO . a1 - o )-V
Primary. .. ., !name E-mai