Homestead_Black INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Sherri S.Hudson Closing Manager
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
Ciry,State,and ZIP Code Telephone Number E-mail
E?SEL'L'ER(S)/GRANTOR(S) P's°u. , .r"'.r . .- _±. =C .tea-`x'.:, ;.s; =°• ._ es, :r--^,r .._3' A ":yam."--.gai
Kevin K O'Dell • Tammy A O'Dell
Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
573 Srl f, 3 Re 3rres k 293 W a so 3
Address(liver
ga/,
Under penalties of perj ,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and cortt,
ev/�j �ld by law,and is prepared in accordance tyi[h -1.1-5.S,"R rty Sales Disclosure Act".
Signature a eller T-Signature of Seller
Kevin K O'Dell //4-1& Tammy A O'Dell r'`/
H • 911(4 _
Printed Name of Seller Sian Date(M.M/aDIYYY1) Printed Name of Seller Sign Date(M.4/DD/11111
tr.BUYER(S)%GRANTEE(Sf=APPEICATIONiFORP,ROPERT,Y,TAX DEDUOTIONSkIDENTIEMEC ITEMSiTHAT.APPLY „•'_-+ :
Shawn N. Black EmNakayama
Buyer appears
Buyl-Name as on conveyance nndocvmen[ Buy er l-Name as conveyance
724 Old Mill Lane 724 Old Mill Lane
Address(Number 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 A'• `s
YES NO CONDITION YES NO CONDmON c...
YES
12 ❑ 1.Will this property be the buyer's primary Fl ❑ 3.Homestead "Up7
residence? Provide complete address of primary ❑ 12 4.Solar Energy Heating/Cooling System TOR
residence,including county: ❑
5.Wind Power Device
Address(Number and Street) ❑ 12 6.Hydroelectric Power Device
crysmre ZIP Code County ❑ r 7.Geothermal Energy Heating/Cooling Device
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 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 count(• .)
Address(Number and Street) �/-- s� / - -'
Ciry,State ZIP Code County /At0-�af -C -/60 - WY 1s7 -0a7
Primary property awnercontact name E-mail