Homestead_Bolden 1
• INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - - - - -
LANA C. HARPER CLOSER
Pte parer of the Sales Disclosure Form Title
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES. LLC
Address(Number and Street) Company
EVANSVILLE, IN 47708 812-468-8485
City,State,and ZIP lode Telephone Number E-mail
E.SELLER(S)/GRANTOR($) - . . _ .. _ - -- - -
JUDY I YNN OLIVER
Seller I-Nonie s ppears pu tonveipnce run,ent Seller 2-A'onie as appears on eonvyunee document
101,1e' Al MS-I- S
QQ��ymb• Strr / //) Y7660 Address(Number and Street)
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".
Si nature rayPfT I� �� Signature of Seller
JJnnlM Namr, !Seller Sion Da:e(A4/UD/YYI'f) Prated Name of Seller Sian Date lMM/DU/1TY11
.BUYER(SJ/GRANTEE(S _APPLICATION FOR PROPERTY_TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT-APPLY .
%�Dr N Name �/- aJrlo me it L H i D
Buyer I Name as appron on conveyance document Buyer 2 Name as appears on mnvynnr m t
a,U 7 A) . PZI-F/L S1
yid ess(Numb rand Shen Address(Number and Street)
i 2l1%2('(i)l'f) // J`f X`4 I MAY 7 2015
TIIE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR 11115 PROPERTY. IDENTIFY ALL OF TII gs�jB�yR//"'•••1r0 U NTY AUDITOR
YES NO CONDITION I YES NO CONDITION
12 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 151 4.Solar Energy Heating/Cooling System
Ai e Fe e c luding county: ❑ 5.Wind d Po\ver Device
/' //� /��nrr id. rr,et) I jI {/-7� ❑ 0 G.Hydroelectric Power Device
L� /�-�"""` l.t � //V ����U vl��L�� ❑ El 7.Geothermal Energy Heating/Cooling Device
Crgt State ZIP Cade County
0 ❑ 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 ❑ 12 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
n in ��,,�/faq county: below.Please see instructions for more information.
�) / `Sr `YY71
Not available in all counties.)
/Urns(Number and Street)
Mir SOD /N '(7WQ C/A.Ct ) 210.iy-1 g-1163- Coo 307 007
City,.State ZIP Code County
Primary property owner contact name E-mail