HomeMy WebLinkAboutHomestead_Haubold (4) A SALES DISCLOSURE FORM SDF ID: Page 2
D: PREPARERt:?F : t• -� _° -_ '."` - " r <� :"'r9
Karen S.Creek Closing Agent
Preparer of the Soles Disclosure Form Title
501 Main Street. Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville. IN 47708 812-421-4000 karen.creek @jeffbosse.com
City.State.and ZIP Code Telephone Number E-mail
E:SE LEE R(S)'/,G RANI:OR(sf.c.s>? '_.' 17,2 - C 1±; _..!'..`: r -i.: _ _ - s y _ ,.FE
William D Millar Joyce N Miller
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
3o 3 ,✓- s ryl a✓e, 303 ru• 'W' 13oc
Address(Number and Street) Address(Number and Street
• fri lc •r-toh 44 ?670 • rr) Ice- w C -/7670
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 Property Sales Disclosure Act".
Signature of Seller Signatur 4.eller
William 0 Miller 2$'20f S Joyce N. • filer 04'aq.(S
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO 3. Homestead FILED
Q ❑ 1.4Vill this property be the buyer's primary Q ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System
residence,including county: ❑ 12 5.Wind Power Devic /�PR 2 9 2015
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
❑ 0 7.Geothermal Energ ing Device
City,State ZIP Code County
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 8. Is this propC�tlfj&AEkhtt9TYegtaf�TQrty?
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.
Not available in all counties.)
Address(Number and Street) -t.
eati sPri.te 51. a ab-it -12-1o1-00a-cs is-era g
C! State ZIP Code County
��� vt t G fan