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',�4�DUNA $AI.ES DISCLOSURE FOR�f $DF ID SDO m 713073 Page 2
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Prepnreru/ffir5vlaDisciomrefann TiNe
I605 SE Martin Luther King Jr. Blvd. Southwestern Indiana Land Title
Addrrss (Nvm�veicnd Strret)
Sdfer 1- Nvme u oppmrs om m�veyvnae docummo
Bonnie E. Cox
Selfn 2� Name af apyevrs w rnnveyvnce docvmen:
P.O. Boz 277 1228 S 350 N/
AJdrrs(Num.6r�mASveetJ Addras(Nam6rrond5nen)
Crane,IN 4i522- Princeton,IN 4767o-
Clry, Smte, andZl�Cede bry, Sm:e, nM]IP CoCe
Under penalties of perjun�, I hereby certify that this Sales Disclosure, to the best oPmy knowledge and belief, is true, correct
and!/S ompfete as requ/ir�ed byjla«�, �an�d is prepare,rd inI accordance wipth IC 6-1.1-S.S, "Real Propefrty� Sa�les Disclo�s% re��lct".
K 6ria�GL �. Cl JC (3`l . L/t yJln.� .S. Nud S o�� fl/%� /".1)Awc.t� C�- �Y �is �-l-�.Pn�.� r{-G�c�S�:'I .�4J
:S�ei.. S.
P. Kares 111
7921 5 400 4V �
Adsress(Numbe: aml50-rrtJ
FL Branch, IN 47648-
Ciry.S[a[t and ZfPCMe
THE SdLES DISfLOSUNE PoRh1.NAY BE USEU TO APPI.Y PoR CERTdIS' DEDURIOYS FOR
XQ � 1.4Vi11 [his properr� be [he buyer's primary �
residence? Provide mmplete address oi primary
. residence, induding county:
7521 S 400 `N
Addras(NunberandSheeQ
Fl Branch, IN 47648 GIBSON
Ciry.Smre ZIP C�x'e Coenry
Q � 2. Does the buyer have a homescead in Indiana [o be
vacated for [his residence? If yes, provide
complete address of residencz being vacated,
including coun[y:
10725 SCHAEFFER ROAD
Addras (Nc:a6er and Sare:)
Evansville, IN 47720 VANDERBURGH
Ciry.SmhZlFCode Ceunry
KertiJ. Kares
7921 S 400 W
PL Branch, 1��4FiQ
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APPLS.
4. Solar Energ�eating/Cooling Sysrem
5. Wind Power Device
6. Hydroelearic Power Device
7. Geothermal Energy Heatlng/Cooling Device
8. Is this property a residential rental propercy?
9. lNould vou like to receive [ax statements ior chis
property via e-mail? (Provide rontoct informotron
beloiv. Please see instructions for more in%rmation.
iVOt available in all counties)
o?� - /�.,�.� ��ao _ 600. /G 3--6a-S
Primarvorouemmvnermnmc:name br..ci(
Under penalties a(perjury, 1 hereby certify tha[ this Sales Disclosure, to the best of my I:nowledge and belie(, is true, correct
and complete as required 6y law, and is prepared in accordance with IC 6•1.1-5.5, "Real Property Sales Disclosure Act". (UOte:
Spouse information, Sodal Security and Driver's License/Other numbers are not necessary if no Homestead Deducdon is
b,e1ing filed.) �� �/ i/ rI-� ' / ,
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