Homestead_Bodrie INDIANA"SALES DISCLOSURE FORM SDF ID: Page 2
D?:PRE$ARERI JL
Laura Rinincier Closing Coordinator
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
City,State.and ZIP Code Telephone Number E-mail
Michael Weaver Maria Weaver
Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
4177 E Valley Pass 4177 F Valley Pass
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639 Haubstadt IN 47639
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co up].t: as required by law,and is prepared in accordance s • hh IC 6-1.1-S5, "Real Property Sales Disclosure Act".
ifs!;,; alegl, i r!L-il4 , Z(�.el�
gnatureafSeder Signature of-Seller
Michael Weaver Cl/Y /J Maria Weaver & 7//7
Printed Name of Seller -Sig Dat (14MMD/YYYY) Printed Name of Seller Sipn,Dafr IN!DIWYYYY)
F�BITAR(Sj GRANTEES) ARtati ATION EOR�P:ROPERTlnTAX.DEDU.GTIONSLIDENTIFItALL ITEMS, , li
Eric M. Bodrie _Shannon L. Bodrie al! l �{`
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
•
420E795S 420E795S APR r1 2017
Address(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY DE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. .
YES NO CONDITION I YES NO CONDITION
igl ❑ 1.Will this property be the buyer's primary El ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ ig
1009, cartridge Dr. 5.Wind Power Device
Address(Number and Street) ❑ 12 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson
0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
IN ❑ 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 ❑ TA 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.
420E 795 S Not available in all counties.)
Fort Branch, IN and
47 48 r+ I q-36-��� 361-1
Fort Branch, IN 47648 Gibson �,�—
City,State ZIP Code County
Primary property owner contact name E-mail
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