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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER r - - _ _ S. r __
_ - •ate.:_ ::-i
Chris Lenfers Closing Agent
Preparer of the Sales Disclosure Form Tide
•
501 Main Street, Ste. 101 Bosse Title Company
Address(Number and Street) Company
Evansville,IN 47708 812-4214000
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)-- `` - - .- C. .
Tambra J.Will
Seller I-Name as appears on conveyance document - Seller 2-Name as appears on conveyance document
ID 1517 S• h{u,►.,hr'S C,wss1Ai Dr
Address nber'and Street) Address(Number and Street)
f7 bciia+ � '474031
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co plet e /Ir'ye�gjuirf°y, by law, is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
-�tLt •
Signature o eller /' /1c7 Signature of Seller
Tambra J Will t� frq/C �
Printed Name a(Seller Sian Date( M/DO/YYYn Printed Name of Seller Sian Date(MM/DO/YYYi)
F.BUYER(S)/GRANTEE(S)T-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY-ALL ITEMS THATAPPLY- .
Chad D.Will
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
10147 S.Hunters Crossing
Address(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
a ❑ 1.Will this property be the buyer's primary lEr ❑ 3.Homestead
residence? Provide complete address of primary ❑ g"4.Solar Energy Heating/Cooling System
residence,including county: ��/
/0/4/75 flt,n +ers Cr0ss /n0 ❑ LJ S.Wind Power Device
,Iddress`Numb randStreet) J ,p ❑ d 6.Hydroelectric Power Device
/7a[a.US4att, 1 n' 477& 3 9 &iv sB/1 ❑ R' 7.Geothermal Energy Heating/Cooling Device
City,State ZIP ode County
❑
Er a2.Does the buyer have a homestead in Indiana to be ❑ Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
d?-18.3 4 300 do /876 .P o f
City,State ZIP Cade County
Primary property owner contact name E-mail
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / 5-92)
FORM
HC10
YEAR
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INSTRUCTIONS: See reverse side lor (ling inshuctions. �
CERTIFICATION STATEMENT
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I(VJe) • certify tha on the 1st� ay of March, 79_
I(We) occupied as our principal place of residence the following described real property for which a Homeste �Property Tax Cretlr[ is hereby claimed:
❑ I(VJe) owned ❑ Are buying under contract LLI 'r
(;� �N r �.; � untTCR
❑ Have a beneficial interest in the entity that is liable for ihe property taues on the property and that owns the pt�rty or is biry`irig�i nAer a contract.
CONTRACT RECORDED
It buying on conVaci. Fee Simple ownefs name
Recortlers ottice where comract is recorded � � Record number Page
PROPERTY DESCRIPTION
Counly -� T 5 p Taxing dis�' 'ry, , town5hip)
5-0�1 -�l
Parcel mber L escrip6on
0-a/�� y- 0 d �_ -/. �G�- D�
If any poNon ol ihe residen6al structure or ihe land not exceeding one (t ) acre ihat immediatey surtounds thai swcture is used to proOuce income, tlescribe Ne use antl portion of
ihe pmperry ulil¢ed to protluce incame.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Gounry Township Counry Tovmship
�. . � , ' Si o( i
�ereby certity the above statements are W e, conect and complete. '
Adtlre (numberarMSireel, ciry, slate, ZlPCOde) p,� � /L �� �
D �O d%,S u�l � �. `�
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceedinq 1(one) acre immediately (� �
surrounding residential improvements. -
Otherland (2)
Total land (line 1 plus line 2) (3)
� Dwelling (4)
Residential improvements
Garage (5) �
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby Certity Ihe above is true, correct, and Signature of Pssewr Date signed
complete.
Veritying action - Signamre of Autlitor Date signed
STANDARD DEDUCTION ALLOWANCE
79_ Pay 79 _
er o( 7/2 Homestead c�
r
ion or 52.000
Signawre ot AuEitor Date signed
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