Homestead_Blanton (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Kathy Masterson CLOSER
Preparer of the Sales Disclosure Form Title
501 Main Street,Suite 101 Bosse Title Company,LLC
Address(Number and Street) Company
Evansville,IN 47708 (
E-mail
E.SELLER(S)/GRANTOR(S)
Jeremy Edrington
Seller]-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
205 S.Walters St
"Address berand Street) Address(Number and Street)
Fort Branch, 648
City,State,and EPCode '� • City,State,and ZIP Code
• emyedrington@live.com ____.------ -------------_
.Telephone Number --------- —.-. ------7a1ep�one Number E-mail
Under penalties of perjury, I_ l ereby-i@rnfy that this Sales Distlns tounebest of my knowledge and belief, is true, correct
and complete ' y law,and is prepared in accordance with IC 6-1.1- , er Sales Disclosure Act".
Signature of Seller Signature of Seller .
Jeremy Edrington 02/05/2020
Printed Name ofSelier Sign Date(MM/DD/YY17) Printed Name of Seller Sign Date(MM/DD/YYYY)
i
BUYERS)/GRA E(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS_IDENTIFY ALL ITEMS THAT APPLY
Melissa S.Blanton Diana L.Koester
_ ,8 er.2.4wneasappearso eyance document 8uyer2-Name as appears on conveyance document
400 S.Main St Apt B 400 S.Main St Apt B
Address(Numberand Street) Address(Number and Street)
` Feb U6 2U2
U/ E-mall
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO .IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION i4�J�(�trR
" 0 1.Will this property be the buyer's primary c ' ❑ 3.Homestead GI COUNTY AUDITOR CB
residence? Provide complete address of primary —
residence,including county: 4.Solar Energy Heating/Cooling System
0 "1 -;' 5.Wind Power Device
205 S.Walters St. ❑ " ' 6.Hydroelectric Power Device
Address(Numberand Street)
❑ 7.Geothermal Energy Heating/Cooling Device
Fort Branch,IN 47648 Gibson 0 8.Is this property a residential rental property?
City,State ZIP Code County
❑ r 9-Would you like to receive tax statements for this
0 2.Does the buyer have a homestead in Indiana to be property via e-mail? (Provide contact information
vacated for this residence? If yes,provide below.Please see instructions for more information.
complete address of residence being vacated, vat able in all counbe .
including county: •
Address(Numberand Street) 26-19-18-303-000. 767-026