Homestead_Dawson (6) •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:PREPARER _ . :_ - '., - `.. •
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 sherri.hudson(@jeffbosse.com
City,State,and ZIP Code Telephone Number E-mail
. .-
E:SECLER(S)/GRANTOR(S): :<:
Rita S Sheridan Trust Agreement
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10950 President Circle
Address(Number and Street) Address(Number and Street)
Indiananolis IN 46229
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".or
'Signature of Seller I Signature of Seller
By'Ronnie Coghlan AIF for Rita S Sheridan Tst Oi+/Od2(:20/-
Printed Name of Seller Sian Date(MM/D /YYM I Printed Name ofSeller Sian Date(M.M/DO/1Yri1
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX'DEDUCTIONSLIDENTIFY ALLITEMS.THAT APPLY . .
1 .
Angela R.Dawson '�
�. 8 pp appcapl mE ( `�ent�� Buyer 2-,tame as appears on c••ve an d•:merit : i
ll]r t�jJ U Jltl'/v` .111^CSL�.j, r,
7 ..filer\ondgtrrejp-1� ``'(t1 , 3 Lj,�r'n7O Address(Number and Street) JUN 9
``--�r�. ��l/l/....1l��''1ICC1) 1 u'1. �r�' `✓. ( V/ r 7015
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE'^•"M'/4'. 0DfrOR
ITS NO CONDITION I Y67,..--
ES NO CONDITION
71 ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ igi 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 12 S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ ri 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 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 county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
Ciry,State ZIP Code County 24p -112-/7ado OOQ1�/oQ r1X
Primary property owner contact name E-mail