Homestead_AkinINDIpNA SALES DISCLOSURE FORM SDF ID:
D'PREPARER�a��43�� � "?�a'.:==�'i�� r.`�_i � >`
CHRISTINA M LENFERS CLOSING AGENT
Preparero(the Sa/a Diulasure Form Title
i507 MAIN ST STE 707 BOSSE TITLE CO
Addras(Num6erand5vre[J Compony
EVANSVILLE IN 47708
E�mall
BETH ANN KRUSE
Seller7 � Name as appears on ronveyunre dacument
Addre¢ (Number and StreetJ
- Name as appears on conveyanre document
Addres(Num6erandSveeQ
liry, Smre, ond ZlP Code
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, [o the best of my knowledge and belief, is [rue, wrrect
and co plete as r qwred by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Proper[y Sales Distlosure Ac[".
��,� �. �.�
SignamreofSeller � Signawreo(Seller
BETH ANN KRUSE L7C0' IC�' I I
Buyer 1
-
-Namevsappearson
EVANSVILLE IN 47720
Ciry, Sru[q andZlPCade
�
THE SALFS DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCf10NS FOR THIS PROPERTY. IDENTIFY ALL OF TNOSE THAT APPLY.
Q � 1. Will this property be [he buyer's primary
residence? Provide complete address of �
residence, including county:
Address (Number and SveetJ
liry, Smre 2!P lode Covnry
� � 2. Does the buyer have a homes[ead in Indiana to be
vacated For this residence? If yes, provide
complete address of residence being vacated,
including county:
Address (Number and SveetJ
Ciry, Sm[e ZlPCWe
❑ 0✓
❑ ❑✓
❑ a
❑ ❑�
❑ ❑✓
3. Homestea
4. Solar Ener eaang/Cooling Sys[em
S. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Headng/Cooling Device
8. Is this property a residential rental property?
9. Would you like to receive [ax statemen[s for this
property via e-mail? (Provide contact informotion
6elow. Please see instructions for more information.
Not available in all counties.)
.� �� _, a, a. 3v � ce�o y,�� 5 oa
Counry
PdmarypmcerR'o�erconruc[name E-mail
Under penal[ies of perjury, 1 hereby certify tha[ this Sales Disclosure, to [he bes[ of my knowledge and belief, is We, correc[
and complete as required by law, and is prepared in accordance wi[h IC 6Q1-5.5, "Real Property Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deducdon is
eing file .) � _ � � ^ ' n� J,��/�
r��11 / 1 � f` (
. r,.y,�,� l,C.a
SignamrtoJBvytA Signuo�reoJBuye ouse
�/
LastSDigiuofSocial5ecuriryNumber LastSdigiGSO%Buyer2/SpouseDriver's Smte LostSDigiGSO�SocialSecunry
Number License/lD/OtherNumber