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HomeMy WebLinkAboutHomestead_Niehaus INDLANA SALES DISCLOSURE FORM SDF ID: _ Page 2 :D`.-}PREPARERSt-t -';- 'A-cl%-...--� .tip - -. �... -, ._{ _ " `til.:k �> ". ._ . .-5 �-_, Becky King Closing Services Preparer of the Sales Disclosure Form Title 7820 Eagle Crest Blvd.,Ste 201 Regional Title Services Address(Number and Street) Company Evansville, IN 47715 812-759-5555 becks.kinq(@regionaltitlellc.com City,State,and ZIP Code Telephone Number E-mail if SELLER(S1161iAlWOR(S)r s ••• r aAct ' � !a=°_'=F w ° fraYea=_ rreifit _L l• Brooke I eanne Besing Shawn Fric Besing Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document • 202 S Mill St same 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 a complete as required by law,and is prepared in accordance lt• IC 6-1.1-5.5,"Real Property Sales Disclosure Act". /Slgrtawre ofSeler Signature ofSeller'j. 1rr ll LWO• . \\ Brooke 1 eanne Besing d' nj -ft Shawn Eric Besing '` `I b-h• IC Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name 2JSeller Sian Date(MM/DDmYY) ,FF•... • S `,GRANTEE Sla PPLI CATIONSOWPROPERTYJFAXDEDUCTIONS _IDENTIFY-ALLITEMS:THAT,APP,IsY Sandra K. Niehaus - • Buyer I-Name as a.. -. •. conveyance document Buyer 2-Name as appears on conveyance docur _ EZSU Address(Number(Numm UB ber and Street) Address(Number and Street) • N Fort Branch, IN 47648 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPS: n c a . L OF THos&tg A Pdt YES NO CONDITION YES NO CONDITION VV COUNTY 41,,- 0 ❑ 1.Will this property be the buyer's primary igi ❑ 3. Homestead OR residence? Provide complete address of primary -EMI . -- . - - a Heating/Cooling System residence,including county: n 5.Wind Power Device i 20?S Mill St ' Address(Number and Street) n NI 6. Hydroelectric Power Device Owensville, IN 47665 - Gibson ❑ 1g 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County gi ❑ 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 ❑ 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 information. 2230 W 950 S Not available in all counties.) - Address(Number and Street) �/ / Fort Branch, IN 47648 Gibson 0 /9-/,_ilGlv?- �.�V - 0 v3og City,State ZIP Cade County Primary property owner contact name E-mail