Homestead_Bozarth INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Timothy Shea Processing Coordinator
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 •Regional Title Services
Address(Number and Sireei) : Company
Evansville,IN 47715 : (
City,State,and ZIP Code Telephone Number E-mail
ar-,M150 Mageag:g ate Ot It-0.5f1WASMA,iti AitraMagegaikVavait Olaf argaRgrotlirdlgaWNASAW
Phillip-M:-Minttis- Ph i 11'p m. Mivt In I's rir
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
409 N Main Street
Address(Number and Street) Address(Numberand Street)
Owensville,IN 47665
state,and 1.11"Lollb i June,and zw Lade
Telephone 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
Phillip M.Minnis f?11
IIMAr)
Printed Name of Seller Sign Date(M iDD/Y(VV) Printed Name of Seller Sign Date(HAVDD/YYYY)
WiltiggitaiMittiM-AffiffieltialkittliddilitiVOAMOMMtrigitioggimmtitatimommm*atatam
Lyle Bozarth
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
103 N 3rd Avenue : 103 N 3rd Avenue
Address(Number and Street) Address(Number and Street)
Haubstadt,IN 47639 ! Haubstadt,IN 47639
State,
,Telephone Number E-mail
Nov 10 2020
THE SALES DISCLOSURE FORM MAY HE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. .
YES NO CONDITION YES NO CONDITION
40 D 1.Will this property be the buyer's primary •• 0 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary ; IZI 4.Solar Energy Heating/Cooling System
residence,including county:
! Ej Er 409 N.Main Street S.Wind Power Device
Address(Number and Street) E 1Z 6.Hydroelectric Power Device
Owensville,IN 47665 Gibson : 0 szi 7.Geothermal Energy Heating/Cooling Device
City,Sta IP Code count)' ' El 8.Is this property a residential rental property?
0 2.Does the buyer have a homestead in Indiana to be : 0
F
vacated for this residence? If yes,provide 9.Would you like to receive tax statements for this
property via e-mail?(Provide contact information
complete address of residence being vacated,
below. Please see instructions for more information.
including county:
Not available in all counties.)
Address(Number and Street)
Lyle Bozarth 26-17-01-404-000.629-022
CRy,State ZIP Code County Primary property owner contact name E-mail
Number License/ID/Other Number