Homestead_Abbott INDIANA SALES DISCLOSURE FORM SDF ID:' Page 2
ji-PREP 1RERi - , c—,-
Becky King Closing Services
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd., Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555 beckv.kinq(o7,regionaltitlellc.com
City,State.and ZIP Code Telephone Number E-mail
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_E:,SEL'IsER(S)/GRANTOR(S),�._.:,, �' � ,�. ,_ •- — r�-. .. _ .- ._ ., i,�, - .
Arlam C Bush
Seller 1'Name as appears on conveyance document Seller 2-Name as appears on conveyance document
5156 S 700W
Address(Number and Street) Address(Number and Street)
Owensville IN 47665
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 epared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Cignatvre of Signature of Seller
Adam C Bush 10/t4/2016
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/FM)
rEBUYER(Sr&RANTEE(S) AP.PEWATIO FORPROP.ERTNITAXDEDUGTIONS,iIDENTIFY,ALLIjTEMSITHATxAPPCY', � _..
Casandra Abbott
Buyer)-Name as appears on conveyance document Buyer 2-Name as appears on co
407 D
407 W Warrick ittyylll�-�11,, PI
Address(Number and Street) Address(Number and Street) -11-4 -11-1
Owensville, IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE T GY L !{, —
YES NO CONDITION YES NO CONDITION GIBBON COUNTY AUDITOR
[ ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary ❑ Il 4.Solar Energy Heating/Cooling System
residence,inclu ing county: ❑
56 --IOC S.Wind Power Device
dress(Number ands t) ❑ El 6. Hydroelectric Power Device
Uoe'sn%V( \ke S-t v R 1 U(o • G I a SCI'\ ❑ Fl 7.Geothermal Energy Heating/Cooling Device
City State ZIP Ode 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)
a( - )7-o1- 1100 -0o4l a25 oa ;
City.State ZIP Code County
Primary property owner contact name E-mail