HomeMy WebLinkAboutHomestead_Hamm U)IDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER .
D1 t.n(k K.Tt711.'I 1- Closing Agent
Preparer of the Sales Disclosure Form Tide
501 Main St. Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000
City,State,and ZIP Code Telephone Number E-mail
Toby K.Thompson I inda M Thompson
Seller 1-Name as appears op conveyance document Seller 2-Name as appears on conveyance document
joy— S (A. it sT 3CS > r'+I^ kJ. 57
Address(Number and Street) Address(Number and Street)
T• r$-,vt%2 T,v . 474 r' r7' !S rfl-,va-S a- N iG tP
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 66--1.1(-55.5, "Real Property Sales Disclosure Act".
Signature of Seller Signature of SellerC ' I�,
+� , CItIZit-
.. nn• •. �sit�I i -u..: i.:.. L �1�JindaM Thompson
Printed Name of Seller ' / Sian Date(,NM/DD/Ym) Printed Name of Seller Sign Date(MM/DD/MT)
F..�BUYER SS �G�RANTEE(S)-APPLICAT ION:FORPROPERTYTAX DEDUCTIONS-IDENTIFY ALL'ITEMS_TTHAgT APPLY'
appears on conveyance document Buyer 2-Name as appears on conveyaoct�t�erp t-1
gg $ BBH M BBB
4748 Chatham Drive
Address(Number and Street) Address(Number and Street)
Evansville, IN 47714 OCT 2 9 2014
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF Tkt TITATAPLLYt I Y .AUUI I OH
YES NO CONDITION N
0 ❑ 1.Will this property be the buyer's primary N ❑ 3. Homestead
residence? Provide complete address of primary • 0 •, o . - - gy •eating/Cooling System
residence,including county: ❑
NI
1010 S Center St 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Ft. Branch,IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
NI
El IrfX'll( 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 ❑ IS 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.
Address(Number and Street)
6 - 11-/1 ' 1o3 -oo0. 0 ?6 - o ;--•6
City,State ZIP Code County
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