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HomeMy WebLinkAboutHomestead_Viehe -, INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D:PREPARER'- 1 .. ,r-_ _ ••- -— r --- c7:7577117 --- Karen S.Creek Closing Agent Preparer of the Sales Disclosure Form Tide 501 Main Street, Suite 101 Bosse Title Company Address(Number and Street) Company Evansville,IN 47708 812-421-4000 closinq.dept @ieffbosse.com City,State,and ZIP Code Telephone Number E-mail E.SEI:CER(S)/GRANTOR(S) . ____ Anthony J Keil I on Keil Seller 1-Name as appears an conveyance document Seller 2-Name as appears on conveyance document C 10395 Hwy 57 I- 1o3?3 tiw7 5 7 Address(Number and Stree) Address(Number and treet) Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and cam t tete as(equired by law,and is prepared in accordance wi h IC 6-1.1- ,$,"Re Property Sales Disclosure Act". Signaller Signature of Seller APthony J Keil . °y/.2 g/at0/7 I on Keil • Oil-24-TA1l Printed Name of Seller Sian Date(MM/DDMT1) Printed Name of Seller Sian Date(M.e/DOM+Ii F: BUYER(51/GRANTEE(S) AP,PL'ICATION]EOR,PROPERTY,TAXDEDUCTIONS=_IDENTIFYcAhhITEMSITHATAP,PLY. 2. ___ ___ Jay Viehe Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1415 E.950 South Address(Number and Street) Address(Number and Street) , - Haubstadt, IN 47639 _ ' _• THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. Ot/ 2p�� YES NO CONDITION YES NO CONDITION 12 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.HomesteadG/Bs " '' it �, residence? Provide complete address of primary ❑ Q 4.Solar Energy HeatingC/I9 ' 1e em residence,including county: ❑ 0 5.Wind Power Device VO/rOR 1415 E.950 South Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Haubstadt. IN 47639 Gibson ❑ Fl 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 12 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property a residential rental property? vacated for this residence? Ilyes,provide ❑ 14 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) Z10-19 - 3Q -ate a5C) 3 S 5 a a 9 ' City,State ZIP Code County Primary property owner contact name E-mail