Homestead_Bates INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
:D::PREP,ARER._ ��..&__.:?`;_ - -'- -- _. _ ' 7 _ = 1 ---- ,
Karen S.Creek Closing Agent
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.deptiieffbosse.com
City,State.and ZIP Code Telephone Number E-mail
1.Ei,SELLER(5)`/,GRANTOR(S), - — - — --7.• -- •_- - -- -
Kevin Daniel Bogan
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
3083 S. %00 E.
Address(Number and Street) ' Address(Number and Street)
_3n.ktauv e_
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature ofSel er / d 9 Signature of Seller
- L
Kevin Daniel Bogen - 7-/ 7
Printed Name o(Seller Sian Date(MM/M0/Y117) Printed Name of Seller Sian Date(M.N/DD/YYYY)
,+F;,BUYER(S)/GRAN,TEE(S)-AP.PLICATION,EOR.PROPERTY;TAX DEDUCTIONS=IIDENTIFY,ALL ITEMS THAR�RP,LY _
__ __ _ _
1)Q
Clara Marie Bates ,If ,
Buyer l-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 4/✓0
1860 S.Lakewood Circle C`)/✓pS
Address(Number and Street) Address(Number and Street) • / 8io
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPL .
YES NO CONDITION I YES NO CONDITION �( e
❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead `rl
residence? Provide complete address of primary ❑ Fl 4.Solar Energy Heating/Cooling System
residence,including county: ❑
1860 S I akewood Circle 5.Wind Power Device
Address(Number and Street) ❑ 151 6.Hydroelectric Power Device
Fra isco, IN 47649 Gibson ❑ 1g 7.Geothermal Energy Heating/Cooling Device
Cl ,State ZIP Code County
❑ 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 ❑ 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 coun : below.Please see instructions for more information.
101 55d�pa ��r`-t '�� Lk-1�iI1 I s.�.1I V/:1 1//'�l't Not available in all counties.)
Ad s an 1 Ot Street) Z]1 U • 1 G1 /Jf// !!''//,, �^ /q�
City State ZIP Code County ✓'�'�� t�D-r�C/U_C��, �Ov
Primary property owner contact name E-mail
