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Homestead_Jenkins
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 1111:PREPARER- :. �.� _.,x.• 140 �- .�.z45, `r,c -"',=,' 't-,T7 s3`. ;,r:w_. d Christina Ferguson Closing Agent Preparer of the Sales Disclosure Form Tide 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 aE SELLER(../GRANTOR(.) . < . a _ :. c P 't Janet c Currier Revocable Trust Seller I-Nam as appersyn conveyance document Seller 2-Name as appears an conveyance document (f(�Ol.Cl &,fI Y D Address'(NUmber end Street) Address(Number and Street) a lrgj tUL /f1 qtr (ply frz-7-1 II 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". ,gnatmrofSeller Signature of Seller Diane I Currier Successor Trustee 04/29/2016 Printed Name of Seller Sian Date(MM/DO/YYYY) Punted Name of Seller Sian Date(MM/oo/YYYY) F.BU GRANTA . . ' •ATIONiPOR:P,ROPERT.YUTAX DEDUCTIONSEIDEN7`IFY:AIi[:ITEMS;THATAPPIN( s' .___ a- Michelle M.• s uyer1-Name as appears a,convevanc-•. ment Buyer 2-Name as appears on conveyance document • 67.. =Address Mirber`A Street) a. qi 't� Address(Number and THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TH ••se e0/.0 'At . YES NO CONDITION a NO CONDITION • ^fir p . YES Will this property be the buyer's primary (� ❑ t�Homestead ✓dry-- -• residence? Provide complete address of prima ! © 4. r - ergy Heating/Cooling Syit residence,including county: a/?. El IN S.Wind Power Device OR Address(Number and Street) ❑ ig 6.Hydroelectric Power Device City Stale ZlP ode caanty ❑ IN •Geothermal Energy Heating/Cooling Device ❑ 2?Does the buyer have a homestead in Indiana to be ❑ I Is this property a residential rental property? ' El 0 9.Would you like to receive tax statements for this avacated for this residence? If yes,provide 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) So/ City, tate ZIP Code County � _dp /r- /0 -- 000. 03. 00/ ty Primary property owner contact name E-mail