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HomeMy WebLinkAboutHomestead_Martin (16) • INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 DIPREPARER--r -- _-L-_-._ - . - - • - • - .--7 • Sherri S Hudson Closing Manager Preparer of the Sales Disclosure Form Title 501 Main Street.Suite 101 Bosse Title Company Address(Number and Street) Company Evansville, IN 47708 812-421-4000 sheni-hudson(thieffbosse-com City,State.and ZIP Code Telephone Number E-mail ,E.SELLER(S)/GRANTOR(S) _ - - Bradley A Gross Diane M Gross Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document ` '10 S .w. 51. c * u yts ea &s Addi s(Number and Street) Address(Number and Sweet) 14KAt,6s4at+ ZN gni, , JroSR °R-., Y7k3S 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 Pro erty Sales Disclosure Act". Sign.ore Sdler / ./ Signature of Seller Bradley A Gross / A! 3 1 17 Diane M Gross /)'J3 bat Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sion Date(MM/o0 P.BUYER(S)/GRANTEE(S)'APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS,THAT APPLY._ c.......- r -'-_ - James M.Martin 4 Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document If S. west Si- Address(Number and St eet) Address(Number and Street) Haul s4o. J, ill) y76311 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF E AT PPLY. 1 YES NO CONDITION I YES NO CONDITION I l p�❑ 1.Will this property be the buyer's primary ❑ 3.Homestead ff11CC ff� residence? Provide complete address of primary ❑ Fl 4.Solar Energy H i&CgPCoo2A 4ystem residence,including county: ❑ Q 5.Wind Power Device Address(Number and Street) ❑ Fl 6.Hydroelectric OtY - Gry ate ZIP Code looney ❑ I g 7.Geothe Tltrgyart Atrg/ra icllgvice ❑ Ifs B•Is this property a residential rental property? ❑ 2.Does the buyer have a homestead in Indiana to be 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 '�// � incl'uvdin county/ below.Please see instructions for more information. 7/T/ t . West' ST. Not available in all counties.) Mc tbstad1-1/A/ y 63'1 a(9- 33 -Ob- X03 ' 000. 535-b0 S 7 G,bsel City State ZIP Code ' County Primary property owner contact name E-mail