Homestead_Ort (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Haley Lewis Escrow Officer
Preparer of the Sales Disclosure Form Title
7321 Eagle Crest Blvd.Ste.A Foreman Watson Land Title, LLC
Address(Number and Street) Company
Evansville, IN 47715
E-mail
Bruce E.Holder Sherry T. Holder
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1 0 6 thick a o , iv- q 63- CAn'itta,SOU 0 r.
Address(Number and Street) Address(NuAer and Street)
rorf t3 rev. c Et M-. - 73 if 7 6 qg i'v tI(4 brolcioIN }tok.1
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City,State,and ZIP Code
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 c plete as required by 1. ,, ,. ,
• 'Apprepared in accordance with C 6-1.1-5r " al Property Sales Disclosure Act".
Signature of Seller Signature of eller
Bruce E. Holder 2/28/2020 Sherry T. I4older 2/28/2020
Printed Name of Seller Sign Date(mM/Do/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
:),FillitlYERM/GUN TM-S174,AP-PLICAT1.0.FO,RYRO,PERTYL TA;k: b E rip' CTI 0 SIS7JDENTIFYJIL ITEMSIT.' 'T ARPE16:.-._;:::_.2:L,_. :,•.-„_ '
Johnnie M.Ort
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance doct en t
207 N McCreary St
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 %lip
e.o
City,State,and ZIP Code City,State,and ZIP Code
E-mail Telephone Number ‘). A; E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAleggUy.
iv Ty
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary IZI 0 3.Homestead
'I?
residence? Provide complete address of primary 0 Z 4.Solar Energy Heating/Cooling System
residence,including county:
0 IZI 5.Wind Power Device
205 W Vine St
Address(Number and Street) 0 Z 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson E z 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 Z 0 ' 4, 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 0 Z 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 co ties.)
Address(Number and Street)
C7g'-'1,-- /J—
City,State ZIP Code County
Primary property owner contact name E-mail
Number License/ID/Other Number
1