Homestead_Weigman • INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D'HPREPARER_. r.: .• .: =h _ p'. -i- ,-s r' _-fj_t,.
W.
ginMIMM i a a 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 closing.dept @ieffbosse.com
City,State,and ZIP Code Telephone Number E-mail
c E?SELLER(sJzGRANTOR(Sji. .z- — `—•,'- 71_ -.— —'7:--"-__
Art C Butowsky Rebecca J Butowsky
Seller l-Name as appears on conveyance document ' Sell r 2-Name as appears on conveyance document
dr Address(Number and Street) Address(Number and Street)
/y� treet)
}(\/
'\City,State,and ZIP Code City,State,and ZIP Code
Telephone Number E-mail Telephone Number E-mail
Under penalties of perj ,1 here certify hat this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co le s egg¢ 1 is epared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
y/
/ Signature of Seller (,� "Signature of Seller
•
Art C Butowsky Rebecca J Butowsky V
Printed Name of Seller YSign Date(MM/DD/fl'n) Printed Name of Seller Date(M.M/DD/YY1Y)
LEBUYER(S)/-GRANTEE(S)_APPLhICATION;F,OR PROPERTY TAXDEDUCTIONS=:IDENTIEY:ALL N AT. U - _
�(7. Wei man r, r evocahet *rzsf '
Bu- I ypmm appears pn conv nce ocument Buyer 2-Name as appears on conveyance document
CJ.7(LL/OY t/Jt��1 JUN 16 2017
Addrr/>t(Num er ar eeU �� Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
Y
�
ES NO CONDITION YES M1'0 CONDITION
❑ 1.Will this property be the buyer's primary Er ❑ 3.Homestead
residence? Provide complete address of primary ❑ MI 4.Solar Energy Heating/Cooling System
esidence�ir J�udi� county: ❑ igi 7145 �• m1 1�t�lY� S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
City, tate ZIP Code County ❑ 0 7.Geothermal Energy Heating/Cooling Device
❑ 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 ❑ 0 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)
24-I'l - a ► - abo oo)-1 , 79 3 -oat
City,State ZIP Code County
Primary property owner contact name E-mail