HomeMy WebLinkAboutHomestead_Lowe INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
jD4P,REP'ARER "
Erin Fichtinaer _ Title Services
Preparer of the Sales Disclosure Form Title
501 Main Street.Suite 101 __ Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 I 812-421-4000 I erin.fichtingereiefibosse.com
City,State and VP Code Telephone Number I E-mail
EELSEELER(SWGRANTO k(S)
Nicholas Hulsey
Seller I-Name as appears on conveyance data nt Seller 2-Name as appears on conveyance document
x d I R t 1-ie;44 c
Address Number and Street) I Address(Number and Street)
lec/'1]o/2 4. 762c
Email _ Telephone Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an omplete as required by law,and's prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
ri
Signature of Seller y Signature of Seller
Nicholas Hulsey / _1 0`)'6 /1
Printed Name of Seller Sian Date(MM/OD/nTY) Printed Name of Seller Sign Date rMM/00/YYn)
P.B.LIVEP(S.'/GRANTEE(S)(e,AP-',P.LICATIONFOR?P,ROEER•TAWFAXtDEDUG:TIONSEIDENTIF.YfALLIt• MSa 1TiAgREYEE --- i
Jennifer Nicole Lowe g l#
rver I-Name as appenon c.• eyance document Buyer 2-Name as appears on conveyance document
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Address(Number and Street) Address(A"umber and Street)
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City,State.and ZIP Code City,State,and ZIP Cade
Telephone Number - GIBSO COUN I T AUv tiM E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YESr { NO CONDITION YES NO .'
it ❑ 1.Will this property be the buyer's primary R 3.Homest
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county:
❑ 0 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
Ciry,State ZIP Code County
0 6 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 county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
zcao 1s o7 10i Oar) Dal5/ Dad
Ciry State ZIP Cade County
Primary property owner contact name E-mail
Under
Number Litense/ID/Other Number