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Homestead_Church i „SALES DISCLOSURE FORM SDF ID Page 2 ,.2PARER?iv:f- N_ - -i °, `:.: c : is 4 - ' s.::_..- .. -. ..i .. nrri S Hudson Closing Manager /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(Wieffbosse.com City,State,and ZIP Code Telephone Number E-mail {ErSELLER(S)/GRANTOR(S)' i '- _ "...:,:e:: - ._ .r t s: !r .-.f "a.-,3.-c._- - - z 1, . -r _..-- 745 . Fe's Jaunita M McIntire Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 526 S. C- ihsov■ dress(Number and Street) Address(Number and Street) rincelof1 , IN 41670 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct anr-(1)complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". 'f tl. S�d.tz,.cS- A IF �:>•( jC(LLR..`f�rvt Iht�,.�UV J' . u It °!.. _' •�:.; .�Alf Signam ter Signature ofSeler 1 2- I-20 16 By Ted R Goddard as Attorney in Fact a-I-201(0 By Penny e f Goddard as Attorney in Fact S{gn Date Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller ' THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY'O(/ 7"),.. �.,. YES' NO CONDITION YES NO CONDITION ,, F "u( 1.Will this property be the buyer's primary Er ❑ 3.Homestead ��/TOR residence? Provide complete address of primary ❑ Fl 4.Solar Energy Heating/Cooling System residence,including county: ❑ Fl 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device ❑ NI 7.Geothermal Energy Heating/Cooling Device City State ZIP Code County ❑ 111 2'8.Is this property a residential rental property? 2.Does the buyer have homestead in Indiana to be ❑ 9.Would you like to receive tax statements for this vacated for this residence? If yes,provide complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. „_amts -ism - H aTR vk.) ttz ihyrns Not available in all counties.) Address(Number and S ) City,State ZlPCode County Primary property owner contact name E-mail