Homestead_Bradburn INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D. PREPARER
Kathy Masterson Escrow Officer
Prepare(of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 kathy@swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S) f
nr
Pamela S. Fields .,.
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
6330 Country Lane
Address(Number and Street) - Address(Number and Street)
Evansville, IN 47715
Under pe !ties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct
an comp to as reequir d b aw, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
` Jim / I n
Signature of Seller 1 Signature of Seller
Pamela S. Fields R \ZZ\ ti
Printed Name of Seller Sign Date(M D/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Jason Bradburn Melissa Bradburn
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1206 S 1075 E 1206 S 1075 E
. Address(Number and Street) ■-■ - . Address(Number and Street) .
Oakland City, IN 47660 Oakland City, IN 47660
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTI AL 0 THATAPPLY.
YES NO CONDITION
7 ES NO CONDITION
r-3 1. Will this property be the buyers primary Y ❑ 3. Homestead NOV 2 9 Zell
residence? Provide complete address of primary ❑ 4. Solar Energy Heating/Cooling System
residence, including county: J n.----
1206 S 1075E ID H 5. Wind Power Devi
iii
Address(Number and Street) ❑ 6. Hydroelec P fir yj e- .' t..__.
Oakland City, IN 47660 I Gibson ❑ 7. Geothermal Energy Heating/Cooling Device
City,State/LIP Code County ❑ 21- 8. Is this property a residential rental property?
❑ S 2. Does the buyer have a homestead in Indiana to be ❑ J7 K-9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) 9 00-000 1 66-Cap
City,State ZIP Code County Pnmary property owner contact name E-mail