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INDIANA SALES DISCLOSURE FORM SDF ID: 11 Palle 2
D ?PREPARER ='•"
Chastity Helmer
Title Services
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501 Main Street Suite 101
Bosse Title Company
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E9SELLER 5 GRANTO S
Duane Allen Smith
Shcn 1 Namr aatpw w rmn�vnarae. urrmt
Madonna Joe Smith
4lln 7 .s'aeva oAP.ur w.m.elamrdnramrnt
12135 E Hickory Lane
Add,. [.V r gal stmt)
12135E Hidmry Lane
4,k4n. IN.m .n Nrrm)
—0akWndr1N IN 47560
On.Mand Oly IN 47660
Undeq enalties of perjury, 1 hereby certify that this Sales Disclosure;
to the best of my knowledge and belief, is true, correct
and plete as re u d bpaw, an pared in accordance with IC 6.1.1.5.5, "Real Property Sates Disclosure Act ".
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Duane Allen Smith zz�
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Madonna Joe Smith
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hmvd Noav of $Has tt,r ap/fYn7
6 GRAN — APPLI CAT] ON FOR PROPERTY TAX DE
FY ALL ITEMS THAT APPLY'
Throthy Wayne Over
Kathy Ann Wefis
�Z�na Court 17ure+lNvmmmaPlwnae pmre MVmmt
fanrr: IJamrm aP`.ws. mn)onredarvmmt
2233 N Maria Court
nd Anet)
Add.m fNUmDe andsbert)
Hunlincibum.IN 47542
Huntingburg. IN 47542
THE SALES OISCLDSr1RE rORM MAY BE USED TO APPLY FOR CERTAIN OEMI T10NS FOR THIS PROPERTY. IDENTIFY ALL OP Tn OSF: THAT APPLY.
YES No cownmax
YES No CONDITION
Q ❑ 1. Will this property be the buyer's prim
Q ❑ 3, homestead
residenre7 Provide complete address of p ' 1
Wring /Cguling System
�I ) J residen��5}l�.includingcounty:
�d l ,J S Ht C K O Ry L,
❑ S. Wind Power Device
6. hydroelectric Power Device
f NRambrr _
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C"/,,ddiamf_
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U 1 T Y S 0')
Cooling Device
7. Geothermal Energy Heating/
I�I
❑ lGJ 8. Is this property a residential rental property?
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❑ 2. Does the buyer have homestead in Indiana to be
a
vacated for this residence•? If yes, provide
❑ ® 9. Would you like to receive t:IX statements for this
complete address of residence being vacated,
property via a -mail? (Provide contact information
includi lgj�)only:
00U/� I
below. )'lease see instructions(or more in%mmtion.
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Not ovailahleinollcounties.)
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Under penalties of perjury, I 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 1n accordance with IC 6.1.1 -S.S, "Real Property Sales Disclosure Act'. (Note:
Spouse information, Social Security and Driver's License /Other
numbers are not necessary if no Homestead Deduction is
being filed_) N�
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