HomeMy WebLinkAboutHomestead_Lewis INDIANA SALES DISCLOSURE FORM SDF ID: _ Page 2
PRREP:ARER€€ zuv `.s. tF .-,.t _•n. L_eT -'i—°°=a, r"*u
Karen S.Creek Closing Agent
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 closing.dept @ieffbosse.com
City.State,and ZIP Code Telephone Number E-mail
E SE LEE RIS)%GRANTOR(S)� = . ._ •-° ?,:.==�_- z''S a`j. i._n •a`"_,.;i :-.r ..
Mindy R Richardville
Seller l-/Name as appears on conveyance document / Seller 2-Name as appears on conveyance document
r ) C- ` 4.4 5-i- 7Y 5 SO 0`4-4,
Address(Number and Street) ,- Address(Number and Street)
F(.r a- P rrc nor) -rt.) 4 7�4 (-) .
Under penalties of p-i?jury,I hereby certify that this Saley'sclosure,to the best of my knowledge and belief,is true,correct
i dicom a fete a •q t( ed by 1.4 .r. •r•& iY d i actor*a with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
• t I) f 9 4[ A. .�2_ l
Signature of Seller Signature of Seller ' i
Mindy R Richardville 08/0312016
Printed Name of Seller Sian Date(M.N/Bonny) Printed Name of Seller Sian ate(MM/DD/FNYI
WaiDYER(S)/-GRANTEE(S) APPLICATIONI FORP.ROPERTIY;T A%DEDUCTIONS=QIDEN;TIEWALL1TEMST T�PP.I:}' ,_ _ ,,,_',u
MLA)) a1 alb
/Michael A.Lewis Robvnn A.Williams
HuyErl-Abme as appears on conveyance document Buyer 2-Name as appears on conveyance documIent
406 N.West Street 406 N.West Street rh.•.• r. . „
Address(Number and Street) Address(Number and Street) Gi BSON r-OIJNTY AUDITOR
Fort Branch, IN 47648 Fort Branch,IN 47648
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES ) 1O DITION
0 ❑ 1.Will this property be the buyer's primary I ❑ 3.Homestead
residence? Provide complete address of primary Fl 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 5.Wind
n Power Device
Address(Number and Street) ❑ is 6.Hydroelectric Power Device
ap•,State ZIP Code County ❑ Fl 7.Geothermal Energy Heating/Cooling Device
SI
❑ ❑ 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.
cailableinollcountle Address(Number and Street)city,store ZIPCode County _ ciO't - 0°0 . 01 A Q -O,,- L