HomeMy WebLinkAboutHomestead_Bridges INDIANA SALES DISCLOSURE FORM SDF ID: . Page 2
P.REPA ERER R ,- • —
Kandace Rogers Closer
Preparer of the Sales Disclosure Form Title
3101 N.Green River Road Suite 130 Columbia Title
Address(Number and Street) Company
Evansville,IN 47715 812-471-8563 kandace(Wcolumbiatitlegroup.com
City,State,and ZIP Code I Telephone Number I E-mail
I I
E._SE LIER(Sy GRANTOR(',- -- — — —
Alan D Bender Susan M Bender
Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
10650 HWY 165 10650 HWY 165
Address(Number and Street) Address(Number and Street)
Poseyville IN 47633 I Poseyville IN 47633
City;State,and ZIP Code I City,State,and ZIP Codel
E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete dd byand is prepared in accordance with I�6-1.1-5.5,,,.Real ro erty Sales Disclosure Act".
Signature of Seller '�11 L� Signature of Seller
Y I V o��� p
Alan D Bender d'a'� '` \ Susan M Bender a .v1'D "Vl_
Printed Name of Seller Sian Date(MM/D➢/YYYY) Printed Name of Seller ,Sion Date MM/➢D
''F'RUl'ER(Sy'/GR:ANT, E LLAPPLICATIou_oRPROPER yiticx:DEDUCTtONSt4DENIMFY/A1EL.ITiEh,S_THA,T:- , .E
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Deborah S. Bridges Kelly Bridges
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
11491 West 875 South 11491 West 875 South IV 4R,1
Address(Number and Street) Address(Number and Street) ZO19
Owensville, IN 47665 Owensville IN 47665 J
City,State,and ZIP Code City,State,and ZIP Code ON
Y11/Q/7 E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. 04)
YES NO CONDITION I YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary ❑✓ ❑ 3. Homestead
residence? Provide complete address of primary
❑ 111 4.Solar Energy Heating/Cooling System
• residence,including county:
11491 West 875 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
Ciry,State ZIP Code County
❑ KI 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 ❑ Vj 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.)
I Address(Number and Street) r�
•
City,State ZIP Code County a\- (-1- aoi - ( oo- wc�Ss9-c1
Primary property owner contact name E-mail