HomeMy WebLinkAboutHomestead_Rose (3)1\Dla\A SALHS D[SCLOSURE FO[L�t SDF ID 26-2009-7000413 �� Page?
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CHRIS LENFERS BOSSE TITLE ClO51NG AGENT
� PsepanrofNeScfeD"ur(asvre£orm T+Ie
501 MAIN ST STE 101 BOSSE TITLE-
.1Mren (,�•umbvmnl9ree<1 Compam.
EVANSVILIE, IN 47708 (
Cint Smtq m�d LP Code Tdephone A'umbrr E-mai!
RACHEL L CHISM
Se((el.,�'ame m appemt on con�nnrce dorumeiv
602 5 EASNIEW
A reu(,\'umbercrsdSreetl
FORT BRANCH, IN 47648
$¢!!`r - A'mne as appems on com�n�a.rce docvmem
Adfrev (.\'umber and 9rea!
ire. 9ate. and LP Code
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E�mall Tefrphane.\'umba ' E-mai(
n �es of erjury, 1 herebc ertifc tha[ this Sales Uisdosure, to the best of my kno���ledge and belief, is true, correct and
as quir� b�la��'. and is �repared in accordance �rith IC 6-I.L5.5. "Real Properh� Sales Disclosure Act".
U�IIS
MICHAELJ.ROSE
Bin�er -,\'ame u apyrart on
EVANSVILIE, IN 47715
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E-mall
,-i 1. \\'ill [his propem� be the buyers priman� residence?
address of priman• residence, includine counn�:
3075 EASNIEW ST
aat.�, (v„�,5��es,�e��
FORT BRANCH, IN 47648 Gibmn
Circ. Su+e. m�d LP Cade Counn�
[i 2. Does ihe buyer have a homestead to be vacmed for ehis residence? If
yes, procide complere address of residence vacatine, includine counn�:
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Siyrwmre u/ Se(/n
Printvd J'ame ofSel/n Sign Dore (Af If�DD/t]'}7�
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3[iC"1'10\'S FOR THI$
r�3.Homesread
Sysrem
ri 5. \Vind Power Device
ALL OF Tf105E THAT
r 6. Hydrcelectric Po«�er Device
r 7. Geothertnal Enerey Heatine�Cooline Device
r S. Is this property a residential ren�al propem�?
r 9. \Vould you like to recieve tax staremenrs for this propem via
e-mail? (A'm•ide canmci information belorv. Please see !he
inslroctions for mare mformotioa �\'at m�ailable in a(I cwnries.)
O�.Cl//!
Cim,Smte,md7lPCode Cavnn Primorvpmpemon�ner nmctwme -mail
'n er pena ties o perjury', 1 ere �' cerlifr't at this Sales isc osure, to the best o mc I:no.�ledge and belief, is true, correct an complete as
required b)' la�c, and is prepared in accordance ��i[h IC 6-LI-5.5, "Real Propertc $ales Disclosure Act'l (�o[e: Spouse Informa6on, Social Securiq�
and Dri��es's�i�nsq�o[�er numbers are no� necessan' if no Homu[ead Deduc[ion i�,being filed.) �
CONFI�ENTIAL /�
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