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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