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Homestead_AtkinsI,VJIANA SALES DISCLOSURE FORDI SDF ID SDO ID 713486 Page 2 R PREPARER Marge Schellhase Mortgage Loan Officer Preparer of the.Wes Disclosure Farm Tide &]1 Theater L'rive Evansville Teachers FCU ddress (Number and Street) E. SELLERS ' GRANTORS Ronald E. Haines Teresa A. Haines Seller Name as appears on conveyance document Sel1er2- Nameasoppeurs on conveyance document 10610 East 450 South 10610 East 450 South Address(Numberand Sonnet) Address (Number and Street) Oakland City, IN 47660- Oakland City, IN 47660 - Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct compl_et require by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Rea Property Sales Disclosure Act ". and //t•1. �`J Zee ( �7 ��/ eofseller Ignacare of Seiler I �. Hanes 3 -�� -j1 (�-2Sck- N 1f1 n5 F. BUYERS GRANTEE APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFYALL ITEMS THAT APPLY Damon Charles Atkins Buyer I- Name as appears one -once document Buyer 2- Some as appears an conveyance document Addr. (Number and Screen) Address (Number and Street) Oakland City, IN 47660 - , Telephone Number E -mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TH ISP P THOSE THAT APPLY. YES N0 CONDITION YES NO CONDITION X1 ❑ 1. Will this property be the buyer's primary ❑X ❑ 33 Homestead residence? Provide complete address of prima 4. gy Heating /Cooling System residence, including county: 10610 EAST 450 SOUTH S. Wind Power Device ❑ © 6. Hy r lectric Power Device Address(NumberandStreen) Oakland City, IN 47660 GIBSON ❑ © 7• Geothermal Energy Heating /Cooling Device ❑ © 8' Is this property a residential rental property? City, State ZIP Code County ❑ ❑ 2. Does the buyer have homestead in Indiana to be a 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 instructionsfor more information. Not available in all counties.) / �� —/� _� _ 0_J V�� • � � �� CMN{Q Address(Numberand Street) City, State ZIP Code County Primary property owner contact name E -mail Under penalties of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete as required by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note: Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is b g filed ['� afBuyerl /� ✓lI SignatureofBuyer2 /Spouse UUM( )S �'l l�Q Number License /lD /Other Number