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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - _'
Christina Ferguson Closing Agent
Preparer of the Sales Disclosure Form Title
501 Main St.Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville.IN 47708 812-421-4000
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S). •
•
John R Goddard
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
zef s £ b• 4..A.—
Address(Number and Street) Address(Number and Street)
64.6 AI 3$- fele ql)G 3 5
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 law,and is prepared in accordance with IC 6.1.1-5.5,"Real Property Sales Disclosure Act".
1-...M de
stgnatureof5 .er Signature of Seller
John R.Goddard 07/29/2015
Printed Name of Seller Sian Date(MM/OD/WM Printed Name of Seller Sian Date(NN/DDIVYM
F.BUYER(S)/GRANTEE(S)--APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY'ALL ITEMS THAT APPLY _ -
Brittany M. Krohn Brandon L. Krohn
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
380.1 Pea, Tr:: I
AC a• r and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
IN ❑ 1.Will this property be the buyer's primary is ❑ 3.Homestead
residence? Provide complete address of primary El IN 4.Solar Ener a 615 11 I
residence,including county: ❑ Q 5.Wind Power Dev e
205 S.Sixth Ave /�
Address(Number and Street) ❑ 0 6.Hydroelectric P Y[vic2815
Haubstadt,IN 47639 Gibson ❑ Fl 7.Geothermal Ener Heating/Cooling Device
City tate ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be
❑ 0 8.Is this grope n a property?
vacated for this residence? If yes,provide ❑ NI 9.Would coltMOribQCHAMC1-ta-y&Vrirdikr.s for this
complete address of residence being vacated, property via e-mail?(Provide contact Information
_including county: below.Please see instructions for more information.
,�Y� I r r=r -7(-:,,, l Not available in all counties.)
"Address` be���treat,C Trzl.\n)ls v ncJ j41. I R'-31- goo-D00.6g4-00`T
City.State ZIP Code County
Primary property owner contact name E-mail