Homestead_Englehardt (2)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D. PREPARER;- � � _ ._ . .4 ; � _ - :
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ReparerofrheSala trclosnreForm Title
501 Main St. Suite 701 Bosse Title Comoanv
Addres (Number and Sveey Company
Evansville. IN 47708
E-mail
E. SELLER S " GRANTOR S �. :' ' ' - ' - '
Clarence J_ Martin GaudeRe Sarah Martin
Se7ler 1- Name as appears on �onveyance dacvmen[ Seller 2- Name as appears on ronveyanre davmen[
�nD�.wt�. P.� D.e. 5�-��
Address (Number and Svee[) Addr� (Number and SveetJ
F�,�_�n y7�a 5/�
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E-mail Tele honeNumber E-mail
Under penal[ies of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
�an complete as required by law, and is prepared in accordance with IC 641-5.5, "Real Proper[y Sales Disclosure Act".
s,�� Cl��� �.(. �7��
Signamre o�r 5(qnomre ofSeller
Clarence J. Martin 0812 3 /2 0 1 2 Claudette Sarah Martin 08/23I2072
PrinledNameo Seller 5! nDa[e Mu DO PnnredNameo Seller Si nDa[e MM DO
F: BUYER S GRANTEE S='APPLICATION FOR PROPERTYTAX DEDUCTtONS-1DENTIEYAL� ITEMS-THATAPPCY.'-�: ;
Jamie Enalehardt
Bvyer 1- A'ame as appearsan ronvryance documm[ Buyer2 - Name as appears on ronveyante docvmen[
600 S. Hall Sireet
Addrm' (NUmber and Sbee[) Addr� (Number and SveetJ
Fort Branch IN 47648
Ciry,
E-mail Tele honeNvmber E-mail
THE SALES DISCLOSURE iONM MAY BE USED TO APPLY FOR CERTAIN DEDURIONS FOR TNIS PROPERTY. IDEYTIiY ALL OF THOSE THAT APPLY.
YES NO COY�RIOY YFS NO CONDITIOY
�✓ � 1. Will [his property be the buyer's primary Q ❑ 3. Homestead
residence? Provide comple[e address of primary � � 4. Solar Energy Hea[ing/Cooling Syscem
residence, including county: � � S. Wind Power Device
301 S Cum6eriand St
Add��(NUmberand5vtt[) ❑ ❑./ 6. HydroelecMc Power Device
FL Branch IN 47648 Gibson � Q 7, Geothermal Energy Hea[ing/Cooling Device
❑Ciry mteZlPCOde Counry
2. Does [he buyer have a homestead in Indiana to be � ❑� $� �s this property a residenrial rental property?
vacated for this residence? If yes, provide ❑ � 9. Would you like [o receive ta�c statemen�s for this
complete address of residence being vacated, proper[y via e-mail? (Provide conmct information
including county: below. Please see instructions for more information.
Not availa6/e in al! counpes)
Addres(Num6erand5vee[)
07 (oy K •ZY -r.ozcno5'95aa-6
liry, Smrell➢Code Coonry
Pdmarypmperryownerronractname E-mall
Under penalties of perjury, 1 hereby certify [ha[ [his Sales Disclosure, to the best of my knowledge and belief, is [rue, correc[
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Act". (Note:
Spouse'nforma[ion, Social Security d Driver's License/O[her numbers are not necessary if no Homestead Deduc[ion is
bein �Ied.L
Signaareo erl SignaNreofBuyer2/Spouse
LastSdigirsofBuyer]Driver's Sta[e Last50igirsofSocialSecuntyNum6er LastSdigitsof@uyer2/SpouseDriver's Smte. LastSDlgicsafSocial5ecunry
License/(D/OtherNum6er Number Lirense/lD/OtherNumber