Homestead_Stuckey Sr INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER -
Karen Creek Closing Agent
Preparer of the Sales Disclosure Form Tide
501 Main Street Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000
CIO,.State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) -
Trustee of The I orel R&Bertha L Cooper Revoc I wing Trust
Sel 1g a e asappers on conveyance document Seller2-Name as appears on conveyance document
y� ' o 0-t sse) (Sat ytA_
pd4rp'S(Number [L'S y 47il� Address(Number and Street)
. pl(
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 I Signature of Seller
4/2'3/l5
Printed Name of Seller Sian Date(MM/DD/YYYYI Printed Name of Seller s Y iar t M/DD/YYYYI
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL IT NIS K,i Af Y/ •
ony Ray Stuckey.Sr. Kimberly Ann Stuckey
a.ryo. .h..,ros.r�,.rao on conveyance document Buyer2-Name as appears on conveyance docONH 8 g015
tt O
8293E.900 South 8293 E.900 South J L J
Address(Number and Street) Address(Number and Street)
Elberfeld,IN 47613 Elberfeld, IN 47613 n! n ��
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YFS NO CONDfTION I YES rnvnsnn•
Er ❑ 1.Will this property be the buyer's primary �� 3.Homestead
residence? Provide complete address of primary .Solar Energy Heating/Cooling System
residence,including county:
❑ 5.Wind Power Device
Address(Number and Street) ❑ 6.Hydroelectric Power Device
❑ 7.Geothermal Energy Heating/Cooling Device
City,State Zl ode County
El 2.Does the buyer have a homestead in Indiana to be El 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 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)
€94 - AO"' 29.-• al a0 —000 . / X/—oo/
Ciry,State ZIP Code County
Primary property owner contact name E-mail