Homestead_Vaught •
I INDIANA SALES DISCLOSURE FORM SDF ID:
Paget
D.PREPARER •
•
KATHY RENEE MASTERSON CLOSING AGENT
Preparer of the Sales Disclosure Form Title
501 MAIN STREET BOSSE TITLE COMPANY
Address(Number and Street) Company
EVASVILLE IN 47708 812-421-4000
Qty.State.and DP Code Telephone Number
E-mail
E SELLERS)/GRANTOR(S)
RYAN T HFLTSI FY .
Seller I-Name ar appears on conveyerncedocunent Seller 2•Nemeas appears on conveyance document
117 S DAMOSA OR
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and c�Qm lete ai r iced law,and is prepared in accordance with IC 6-1.1-5.S,"Real Property Sales Disclosure Act".
Sin
Sgnature of Bee Signature of Seller
RYAN T HFI TSI FY 10192018
Printed Nome of Seller Sign Date(MM/DD/f-rn
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary etf 0 3.Homestead
residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System
residence,including county: 0 m 5.Wind Power Device
104 N VINE STRFFT
Address plumber alla Street) 0 Q 6.Hydroelectric Power Device
HAUBSTADT IN 47639 GIBSON ❑ Q 7.Geothermal Energy Heating/Cooling Device
City.Stare---DP Code County
0 e ��� ]]] 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 ❑ ❑ 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)
26-19-31-301-000.283-009
City,State vp code County
Primary property owner contact name