Homestead_FleetwoodINDIANA SkLES DISCLOSURE FORM SDF ID:
Robert M. Becker
Preparer oJrhe Salu D'¢dosure Form
P. 0. Box 657
Address (Num6er and StreetJ
�sville, IN 47704-0657
��ry, Smte, and ZlP Cade
E: SELLER(S)%GRANTOR(S) ' '
JaGc V. Foster, Jr., Personal RepresentaGve of Esta,e of ElizabeN Mn Foster, Deceased
Seller 1- Name as appears m mmeyvnce document
207 SL ChadPS Avenue, Su"r,e 3908
Address (M1'umber ond SveetJ
NewOAeans,LA 70170.3908
rry, sm�, a�a z�r cme
Under
and c�
Title
2
Bamberger, Foreman, Osxald & Hahn, LLP
Lompony
( bbeGcerQbamberge�.com
Telephone Number Email
2� h'ame as appeors om m�veyonce document
Address (Number ond SVeet)
City, Sm[G and ZIP Code
1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
x law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
Jack V. Fwter. Jc �
Wanen'rleetwood
Buyer ] � Name
Add�ess (Number and StreetJ
Fort Branch, IN 47648
Ati.SWte, andZlPCOde
SignaNre o%Seller
Flana S. FleeNrood \
Buyer2-Nameasappe rsomm�veyvncedocvmen[
Address (Number and Street)
Fort Brarrch,IN 47648
City, Smte, and Z/P Code
THE SALFS DISCLOSURE FORM MAY BE USED TO APPLY FOk CERTAI.Y DEDURIONS FOR THIS PROPERTY. IDE.YTIfY ALL OF THOSE TNAT APPLY.
�x ❑ 1. Will this property be [he buyer's primary �
residence? Provide complete address of primary
residence, including county:
777 Iroquds
Address (Num6er nnd Stree[)
Fort Branch, IN 47648 Gibson
Ciry, Smte ZIP Lode Caunry
�x � 2. Does [he buyer have a homestead in Indiana to be
vacated for [his residence? If yes, provide
complete address of residence being vacated,
including county:
501 E Oak SUeet
Address (Number and Street)
rt Branch, IN 47648 Gibson
[iry, Srnce Z1P Code Counry
[ 3. Homestead
4. Solar E eatlng/Cooling System
❑ [ 5. Wind Power Device
❑ CI 6. Hydroelectric Power Device
[I [ 7. Geothermal Energy Heating/Cooling Device
❑ [i 8• fs this property a residen[ial rental proper[y?
j� � 9. Would you like to receive tax statements for this
property via e-mail? (Provide contact injormotion
6elow. Please see instructions jor more in/ormation.
Not availa6/e in all counties.)
�G�.o�d �
01� /y-/A- /O/- ��� 0��
Pnmary property owner conmct name E-mail
Under penal[ies of perjury, I hereby certify [hat this Sales Disclosure, to the best of my knowledge and belief, is true, corred
and complete as required by law, and is prepared in accordance with IC 6-1.1•S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security�nd Driver s License/Other numbers are not necessary if no Homestead Deduction is
Flcetwood
License/ID/O[her Number
�CKCLma ,� • ��i�C,u'L��`1
Signature oJBuyer2/Spause
Nana S. Fleehvood October 2, 2009
�
�� �
Last 5 d(gi6 of Buyer 2/Spouse Driver'S State Last 5 DigiGS o Sacial Securiry
Num6er License/ID/OtherNum6er