HomeMy WebLinkAboutHomestead_Brackett (2) INDIANA SALES DISCLOSURE FORM SDF ID: _ Page 2
ID?PREPARER' "=3-° ;� zS... `-:.-='x 'G" _='_.,Y-... t,_' •' c-,.•-l°,i£' `s'�S '.s
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Sherri S Hudson Closing Manager
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.deoteieffbosse.com
Ciy,State.and ZIPCode Telephone Number E-mail
S6xSE6liERIS)'/GR'ANTOR(S) `'`'.t`-_"L> r.,—:-* •. -r &: 't " r' >' .` h5 xa
Timothy A Fitzlaff ,Jennifer L Fiblaff
Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
//3 A 113 N. fr/aref
nidp cs(NDTmbe?and Street) Address(Nbi2Lesand Street)
PRINCr7oN, /N `/7t 70 Pit ilLo lvn ( fN 1I10 O
.
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complet requir• I I law,and is prepared in accordance with IC 6-1.1-5.5,"Real Prope Sales Disclosure Act".
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rnututSeller Signe 45211
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Timothy A Fitzlaff Jennifer L Fitzlaff 7i • 1/J
Printed Name of Seller SionDate(MM/DD/YYYY) Printed Name of Seller " I • SJwt s,te( 1/DD/YYY19.
a Br- t V
no.nea appears on conveyance document 8ytr2-Name as appears on conveyance docvmei(t�� 2 4 2018
3777 Trail End Road JJVV L
Address(Number and Street) Address(Number and Street)
Boonville,IN 47601
YES NO CONDITION NO CONDITION
0 ❑ 1.Will this property be the buyer's primary ,, 0 ❑ 3.Homestea. -
residence? Provide complete address of primary . olar Energy Heating/Cooling System
residence,including county:
❑ 12 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 ❑ 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.
3777 Trail End Road Not available in all counties.)
Address(Number and Street)
Boonville, IN 47601 Warrick 2'-Vq _\% — l0l— 0 of . l6q -02 6
City,State ZIP Code County
Primary property owner contact name Email