HomeMy WebLinkAboutHomestead_Morgan (6)Addres (Num6erond StreetJ
CLOSING AGENT
rme
BOSSE TITLE CO
Company
EVANSVILLE IN 47708 (
E-mail
.IOHN A BERLIN RUBY R BERLIN
Seller 1- Name as appears on ronveyance dorumen[ Selfer 2� Name as appears om m�veyance dorument
7848S10E 7H4AS10E
Address(NUmberand5veet) dddress(Numberond5tree[)
FT. RRANCH IN 47648 FT. BRANCH IN 47R48
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E�mail
Under enalties of perjury, I hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is tne, correc[
and p[e as re '•ed law, and is prepared in accordance wi -.1-5.5, " al Pr erty Sales Disclosure Ac[".
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namreaf5eller na�tvre f5el
Buyer 1
6230 HATCHETT MILL RD
dddress (Number and So-eeQ
SPOTTSVILLE KY 42458
THE SALES UISCLOSIIRE FORM MAY BE USED TO APPLY FOR CERTAIN DEDURIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TNAT APPLY.
QJ ❑ 1. Will this property be the buyer's primary
residence? Provide complete address of primary
�� � Sresi (�ncey cluding munty:
AI� T �hlc7V nU/r'C�'�.• l � ���o� �i� (S�b��
Ciry,StareZl Cade '� lounry
� � 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addres(Nvmberond5beet)
Ciry, State ZIPCOde Counry
❑./ ❑ 3. Homes
,/ 4. Solar Energy Hea[ing/Cooling System
� Q 5. Wind Power Device
❑ Q 6. Hydroelectric Power Device
❑ ❑✓ 7. Geothermal Energy Heating/Cooling Device
� �✓ 8. Is this property a residential rental property?
❑ ❑./ 9. Would you like to receive fax statemenCS for this
property via e-mail? (Provide conmct informatron
6elow. Please see instructions for more informatron.
Not available in all counties.)
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Pnmary oronerry awner ronma name E-mail
Under penalties of perjury, 1 hereby certi(y that [his Sales Disdosure, to Ihe bes[ of my knowledge and belief, is tne, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[". (No[e:
Spouse informa[ion, Social Security and Driver's License/Other numbers are no[ necessary if no Homes[ead Deduttion is
bein filed.)
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LastSdigi[so(Buyer2/SpouseDriver's StnCe Las[SDigiuO(Sotial5eturity
License/ID/OtherNumber Number License/ID/OtherNumber
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