Homestead_Broshears (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Abbey Moore Closer
Preparer of the Sales Disclosure Form Title
3101 N. Green River Road Suite 130 Columbia Title
Address(Number and Street) Company
Evansville, IN 47715 812-471-8563 abbey0columbiatitlecirouo.com
City,State,and LP Code Telephone Number E-mail
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Rodney Van Rmshears JoAnn Roos Rroshears
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
•
497 Fast 1200 South 492 Fast 1700 South
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,thereby 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 i4th IC 6-1.1-5.5 "Real Property Sales Disclosure Act".
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Signatufe of Seller ignature of Seller
Rodney Van Broshears I I- 17 (la— oAnn Roos Broshears I (- ( —1
Printed Name of Seller Sian Date 14.4/DD/YYYY1 Printed Name of Seller Sian Date(MWDD/YYYl)
'FAUY1PISI/GifANTEE(S):::,-APPEICATIOTODWPROE'ERTY1fAX:DEDUCTIONSIDENTIPfAILITEMS.THATT;APPLY117-7 ti'''':7-.-C-:71. _.-
Kassi L Broshears
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears.4 •a-:,,n •°ruin
1111
240 East 1200 South 1
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Address(Number and Street) Address(Number and Street
Haubstadt. IN 47639
.
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERn. IDENTIFY ALL OFT
.fftriorri%
YES NO CONDITION
WI g 1.Will this property be the buyer's primary YES NO CONDITGABSON COUNTY AUDITOR
g g 3. Homestead
residence? Provide complete address of primary g g 4.Solar Energy Heating/Cooling System
residence,including county:
9 151 S.Wind Power Device
Address(Number and Street) 9 g 6. Hydroelectric Power Device
9 Z 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 Z
9 g 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 9 g 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 co-a 3-0'7- lico - 00
City,State ZIPCode County
Pnmacy property owner contact name E-mail