Homestead_Hall (5) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Chris Sullivan Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
City,State,and ZIP Code Telephone Number E-mail
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Nicholas F.Brusie
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
Pose LVaA?VIkLeI 1M 417IZ_ P
State,ana61P Loae state,and ZIP Loan
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
and com lete asyd by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Nicholas F.Brusie 2j \ \ ( 2- 6
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller '''gn Date(MM/DD/YYYY)
_ :UYER 8', .7 TEE SSA,?A PLICATI'ON Ii OR PRO'P.ERTYTAX-,D:Ei5T ORS- D-ENTIFS?ALt.ITEMSE ATE WMav: . r: `+
Patrick Hall
s on conveyance document Buyer 2-Name as appears on conveyance document
310 Cathedral Manor 3
Address(Number and Street) Address(Number and Street)
Bardstown,KY 40004 99 -�
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDE L OF THOSE THAT APPLY. FILED
YES NO CONDITION S NO CONDITION
-7 El1.Will this property be the buyer's primary ❑ 3.Homestead Mar 17 2020
residence? Provide complete address of primary ng/Coolies
residence,including county: ❑ 0 5.Wind Power Device GIBSON COUNTY AUDITOR CB
11168 W 1000 Road
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Poseyville,IN 47633 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State Z P Code County ❑ 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ El 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide property via e-mail?(Provide contact information
complete address of residence being vacated, below.Ple instructions or ormation.
including county: Not liable in all counties.)
Address(Number and Street) Patrick Ha 26-17-32-100-004. 310-021
City,State ZIP Code County Primary property ow E-mail
,,. Number License/ID/Other Number