Homestead_FrenchINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D.<.PREPARER �. . =.,.-: •> v: r . :;-.. ._ _
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Susan Meier Bosse Title Comoanv
' parero(rhe5alaDtrdosvreForm T(tle
t Main Street Suite 101 Bosse Tiile Comoanv
Address(Numbe�andSVeet] Company
Evansville. IN 47708
Email
ESSELLER S GRANTOR 5 . f` >� �'
Amy M Lane
Seller ]� Name as appears om m�veyantt dacummt Seller 2- Name as appevrs on ronveyana documen[
515 E. VinP Street
Addreu (A'vmber and SVeet) Addrea (Num6er andSPee[J
Ft.Branr.h.IN 47648
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E-mail Tele honeA'umber Smail
Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and,eqmplete as requ ed by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[".
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SignoNreofSelh� � SignoNrrofShcer
Amv M I ane 09I23I2011
PnntedNameo Se(ler SlnnDalefMM/00 PnnredNamea Seller Si nDarefMM/OD
F. BUYER S" GRANTEE S'=APPLICATION.FOR PROPERTY TAX DEDUCTIONS=IDENTIFY AGL ITEMS-THAT APPLY .- '
JacoNn M French Michelle L French
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Email
TNE SALES DISCLOSURE FORM MAY eE USED TO APPLY FOR CERTAI� DEDURIONS FOR TNIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YFS KO CONDITION I
Q � 1. Will this proper[y be the buyer's primary J ❑ 3. Homes[ea
residence? Provide complete address of primary � . o ar Energy Neating/Cooling Sys[em
residence, including county:
5i5 F Vine ctreet ❑ ❑✓ 5. Wind Power Device
Addrea(A'umberand5ure[) ❑ ❑� 6. Hydroelectric Power Device
Ft. Branch IN 47648 Gibson � Q 7. Geothermal Energy Heating/Cooling Device
Ciry, Srnre Z(P Cade Counry
�� 2. Does the buyer have a homestead in Indiana Co be � ❑`� $• Is [his proper[y a residentlal rental property?
vacated for this residence? If yes, provide ❑ ❑✓ 9. Would you like to receive tax s[atemenCS for this
comple[e address of residence being vacated, property via e-mail? (Provide contac[ informapon
incl din ounty: 6elow. Please see instrucdons for mare information.
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Ciry, Smte ZIPCode Counry
Pnmaryproperry owner ronmc[ name E-mail
Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and comple[e as required by law, and is prepared in accordance wi[h IC 6-11-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse informa[ion, Social Security and Driver's License/O[her numbers are no[ necessary if no Homes[ead Deduction is
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' naNrea/ yer] Signamr ofBuyer2/Spouse
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e LasfSDigicrof5otialSewrityNum6er Las[SdigiGSafBuyer2/SpauseDriver's Smce Las[SDigitsofSotialSecunty
Lirense/lD/OtherNum6er A'umber Li[ense/ID/OtherNum6er