Homestead_Brinkley INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARE R' 7 —. ,."*:"`c. .: =,. '.3t-` &;_...'-'�: _:,.W=1' .v.i; "s `" L: . rit-s „nt-uisrf. -.i'1 +rta
Karen S.Creek Closing Agent
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 karen.creek @ieffbosse.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLERS)%GRANTOR(S)::� _ - .-_. tt-a -i_ _.;:,._ 2•.r` . _.z d ,:t:,:-,,:-at 3 c. . >. -,-.,. . ;.'a
Melanie R Scales
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
13385 Prairie Olive
Address(Number and Street) Address(Number and Street)
Evansville IN 47725
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and mplete as require y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
S 17/p/..//2
nature of Seller C�-24 Signature of Seller
Melanie R Scales 0 3- 5"/5
Printed Name of Seller Sian Date OW/DD/YlTYI Printed Name of Seller Sian Date IMM/DO/YYYYI
F. BUYERS)/GRANTEE(S)_'APPLICATION E0R`PROPERTYrTAX DEDUCTIONS1VIDENTIF.Y:ALL ITEMSaTHAT.yAP.PLY` f k x5;1
Amanda C. Brinkley
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
511 W. Pinkney Street
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
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 CONDITION _
❑ 1.Will this property be the buyer's primary r4 ❑ 3. Homestead . .
residence? Provide complete address of primary 111 4.Solar Energy • -at : ooling ystem
including county: ❑
S.Wind Power Devi,AR 12 2015
Address(Number and Street) ❑ 6. Hydroelectric Power Device
❑ 7.Geothermal Ener-� eati r ' g Device
City,State Zl Code County I ,. �i/MAIr
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this pro�ikb(I rrt- 9,-$rJfilt erty?
vacated for this residence? If yes,provide ❑ L 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)
:Z- [ a .o1 - 303 -001. 0/3 Da
City,State ZIP Code County
Primary properry owner contact name E-mail