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Homestead_Stevens (4)
I DI15- AIVASALES DISCLOSURE FORM SDF ID -...��,.z Page 2� ' ' ;T +Dp:�WLna -��E _��?-�., . � tz� rtz �:r�� :' �# � �� �. � r _ChaseSpe i er `_ ' Closer Preparerof the Sales Disclosure Form Title 7820Eagle CrestBlvd Ste 201 Regional Title Services Addr-"ess(Nufnber and Street) Eft---;W-W, s Utz-j�s � zr`r �- -s-�"y.�' s e (�, "'W;;T'e s'_.�..o`�k o-MtN- '.-ti .ac_�:� t. -`mot-L` t-: FAR-_-4 '.�•�-�WW-i? v gr�. - 'W-W t�'�" M °R,�� 'a Tfi - -s�tsv:T:�.,fin_=.�." -`..4�3• �`�` ...��.a���.'.�'� .:.z.�...,�..-�'�'`-`a Bryan J.Haig Elizabeth A.Haig . Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document 106 E Williams St 106 E Williams St Address(Number and Street) Address(Number and Street) Fort Branch,IN 47648 Fort Branch,IN 47648 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 requirecy law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". 4 gnatu ofSe er Signature o Seller Bryan .Haig %z/ilzD O Elizabeth A.Haig 0-131/dad Printed Name ofSeller Sign ate(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) Paid iffir l'/dffai1;tla lA itiatidaiFOR R©PERTg fnkiybrdfiCti OVA ID NtI'.IRYA'L IIRE S?'r:H AVE aWfft Deborah Louise Stevens Troy Everett Bolton Sr. Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 301 W;Cottonwood St 301 W Cottonwood St Address(Number and Street) Address(Number and Street) Patola,IN 47666 Patola,IN 47666 - co ❑ 1.Will this property be the buyer's primary 3.Homestead tco z residence? Provide complete address of primary in -) ❑ Q 4.Solar Energy Heating/Cooling System m residence,including county: El Q 5.Wind Power Device Z..-7 106 E.Williams St Address(Number and Street) ❑ Q 6.Hydroelectric Power Device Fo v :ranch,IN 47648 Gibson ❑ El a!Geothermal Energy Heating/Cooling.Device • a ,State ZIP Code County ❑ 8.Is this property a residential rental property? U ❑ 2.Does the buyer have a homestead in Indiana to be vacated for this residence? If yes,provide ❑ Q 9.Would you like to receive tax statements for this _ complete address of residence being vacated, property via e-mail?(Provide contact information ��°rd(�1 incllud'n county: Ti AAI '� I below.Please see instructions for more information. 3,Q I W t! o ••5 L)hUb Not available in all counties.) Address(N ber Stree 26-18-13-402-000.669-026 ' I 1�r �q/1 r,i� ��J� Deborah Louise Stevens Troy Everett Bolton Sr. City,State ZIP Cade f` ( r'D-i 1) fa lh k` / County Primary property owner contact name E-mall t v l�({f �P I 26-04-25-101-000.102-020 (301 W Cottonwood)