Homestead_Ryan •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Ds;PREPARER - ____v_ _ r . _ _ -.
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 closinq.dept @ieffbosse.com
City,State,and ZIP Code Telephone Number E-mail
EE.SBLLER(5)/GRANTOR(S)'yW- - c----17 _, -
Brian Grips Amanda Gries
Seller I-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
►o5o3 tii Ca.c\e Lane_ 10503 -TIC Ct¢c1e Lana
Address(Number Street)h, TA �� Addres(Number and j ( 41��9
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, o the best of my knowledge and belief,is true,correct
and mplete as required by law,and is prepared in accordance w't/C 6-1.1-5.5,"•eal ;r,perty Sales Disclosure Act".
iti'zw Ll« & di /•
Signature of Seller Signature of Seller
Brian Grips 11/15/2016 Amanda Gries 11/15/16
Printed Name jSeller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
±F:BI);YEA(S)%GRANTER(SJ'=APPLICATION FOR PROPERTY TAX DEDUC- NTIFY.AIiL ITEMS THAT APPLY! ,__
Jonathon R an /J Holly Ryan
Buyer!-Name as a•,.+. on conveyance document Buyer 2-Name as a wrarnifirinveyance document
wi isenhower Lane 519 E. Eisenhower Lane
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt. IN 47639
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THATOPPLY. Clili e
YES NO CONDITION CONDITION property buyer's P ry ❑ 3.Homestead fgSONCO,.
1,Will this be the rima
residence? Provide complete address of primary a —� :• • - , ergy Heating/Cooling System'Q0
residence,including county: ❑ 1-0/it
519 E Eisenhower I one 5,Wind Power Device
Address(Number and Street) ❑ 5 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
111 5 2.Does the buyer have a homestead in Indiana to be ❑ 5 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Fl 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 informaton.
Not available in all counties.) /
Address(Number and Street) C//l0 79. ,5�- ij�/
Y ,o� o6/ '�aa - oo7rr
City State ZIP Code County
Primary property owner contact name E-mail