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HomeMy WebLinkAboutHomestead_Harper (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER Chris Ferguson Closing Agent Preparer of the Saks 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 E.SELLERS)/GRANTOR(S) Carl E Bell and Buelah P.Bell Rev I lying Trustfated Aoril 29 2004 Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document ) SCI$ 2E0 MAcPL_E be- Address(Number and Street) Address(Number and Street) X Ito ol A AtPoUS , /,• 4(.2.3 7 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co plete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". ► i�/44 ate S'-zcasoe_-7-Cos re: Signature of Seller Signature of Seller Theodore M Bell Successor Trustee X 9292t i tf Printed Name ofSeller Sign Date(MM/aD/ra) Printed Name ofSeller Sian Date(MM/Da/YYYY) 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 NO rnMDITtnN__ g ❑ 1.Will this property be the buyer's primary [T ❑ 3. Homestead residence? Provide complete address of primary u el 4.Solar Energy Heating/Cooling System residence,including county: ❑ 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device ❑ 0 7.Geothermal Energy Heating/Cooling Device � y City,State ZIP Code County IJ ❑ 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 copnty: below.Please see instructions for more information. //Di% 5. N riersoAl R D 'ot available in a cou- "- . Address(Number and Street) itmceaiii0sl -r n, 47.-9/ /GUo • az- -/a -OS -Ao3 - o00./ 7/ - 0 a9 City,State ZIP Code County --• .... .. .,., mmctname E-mail