Homestead_Priestly INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER -
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,IN47708 812-421-4000 closing.dept @ieffbosse.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) - - .
Gary A Crnthers Sandra L Crothers
Seller I-Nplas appears/o'n co ace document �r Seller 2-Name as appears on conveyance document
Addrltl_1(NCu[,mber I nd Stree ti f,AIY� 1V�1 Address(Number and Street)
Uct�,riS01 tie
Under penalties of perjury,I hereby certify that this Sales Disclosur to the best of my knowledge and belief,is true,correct
and mplete as requir d b w,and is prepared in accordanc wi IC 6.1.1.5.5,"Re 1 Ppperty Sales isclosure Act".
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re It b /`
Signature of Se r Signature of :{(41.lt,A/
I
i ary A Trot erg r 7' 1 r 0-17/ Sandra L Crothers (
Printed Name of Seller Sign Date(14.N/OD/n111 Printed Name of Seller Sign Date(Ma/DDMTY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR-PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS Tri3A Pgp1.Y
ustin T PriestivTh 1)
Nikki R. Priestly arr q F
er ame as appears on conveyance document Buyer 2-Name as appears on conveyance nt AAA JJJ���
6810 W.400 South 6810 W. 400 South
Address(Number and Street) Address(Number and Street) JUL 1 9 2017
Owensville, IN 47665 • Owensville. IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION Y °^ ION
gi ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestea
residence? Provide complete address of primary ❑ ,/ 4.Solar Energy Heating/Cooling System
residence,including county: ❑ NI
6810 W 400 South 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
NI Li 8 2.Does the buyer have a homestead in Indiana to be El 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)
a4 -/0 - 5 , - tot- Do Y. 533 -Od/
City,State ZIP Code County
Primary property owner contact name E-mail