Homestead_Morton INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Kathy Masterson CLOSING AGENT
Preparer of the Sales Disclosure Form Title
501 Main Street,Suite 101 Bosse Title Company,LLC
Address(Number and Street) Company
Evansville,IN 47708 (812)421-4000
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
James W.Broshears,Jr. Jeanette H.Broshears
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
611 Polk St. 611 Polk St
Address(Number and Street) Address(Number and Street)
Oakland City,IN 47660 Oakland City,IN 47660
City,State,and ZIP Code City.State,and ZIP Code
Telephone Number E-mail 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 complete as required 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
James W.Broshears,Jr. 07/13/2020 Jeanette H.Broshears 07/13/2020
Printed Name ofSeller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYY})
F.B liaF G S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Illiam T.Morton,II
offal veyance document Buyer 2-Name as appears on conveyance document
12821 Sandersan Dr.
Address(Number and Street) Address(Number and Street)
Evansville,IN 47725
State,and ZIP Code City,State,and ZIP Code F I LED
3�? -(,7q4
Telephone umber E-mail Telephone Number Jul 29 2020 E-mail
THE SAL NO ISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDE LLBCONDITION /YF-IMOSE _-
YES CONDmoN YES NTNOIFYY !{
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead G SON COUNTY AUDITOR CB
residence? Provide complete address of primary 4.Solar Energy Heating/Cooling System
residence,including county:
❑ ^3 5.Wind Power Device
611 Polk St. . ElIi/ 6.Hydroelectric Power Device
Address(Numberand Street)
❑ 7.Geothermal Energy Heating/Cooling Device
Oakland City,IN 47660 Gibson ❑ 8.Is this property a residential rental property?
City,State ZIP Code County
❑ [x 9.Would you like to receive tax statements for this
❑ 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, Not available in all counties.)
including county:
Address(Number and Street)
-14— 1$--203 — 0000. 103—�c�7
City,State ZIP Code County Primary property owner contact name -mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, --be of y knowledge and—bilief,is true,correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse inform 'on, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
be' filed.
Si tore of Buyer 1 Signature of Buyer 2/Spouse
William T.Morton,II 07/13/2020
Pri5 gal fi$mr-y: 1 SignDate(M/DD/Y Y) Printed Legal Name of Buyer Sign Date(MM/DD/YYYY)
Last,55digs aj Buyer 1Driver's e Last 5 digits oj ociallSecuurrit Number Last 5 digits of Buyer 2/Spouse Driver's State Last 5 digits ofSocial Security Number
License/ID/Other Number License/ID/Other Number