Homestead_ErnstINDIANA SALES DLSCLOSURE FORM SDF ID: Pavv 7
Ray M. Druley Attorney No. 4759 -26
Preparer of the Sales Disclosure Form Title
N. Church Street, P.O. Box 146 Law Office of Ray M. Drulev
�15
ldress (Number and Street) Company
Fort Branch, IN 47648
E -mail
'EISELCER S GRANTORS _' � t a!• � t __ -
_MatthewA Sturgeon
�yk
Cam, rstall Sturgeon EA Zen x
Seller 1 - Name as appears on conveyance document
6151 Danville Court
Seler 2 - Name as appears on conveyance document
6151 Danville Court
Address(Numberand Street)
_ NeJ�gh. IN 47630
Address (Number and Street)
Newburgh. IN 47630
City, Smtg and ZIP Code
E -mail
,.
Tele hone Number Email
Und r penal ies o erjury, I hereby certify that this Sales Disclo e, t o t he best of my knowledge and belief, is true, correct
jant p e a s equi by law, and is prepared in accardan wi t IC 6 -1. 5.5 " ea R erty Sales Disclosure Act "tureofSeller
S' azure ell r
Crystal L. Sturgeon 02104/2011
Printed Na S n Date MM D Printed Name o Seffer S" n Date MN D
P
- ER S GRANTEE S f.=-
PLICATION•F.OR RROP,ERTY,TAX S- IDENTI , • `=ITEMS THATAPPfiV`. 71 '.??.-
Steven T. Elyneman. Jr.
Tiffany A. nem n
_
Buyer] -Name as appears on yance document
Buyer2- Nameasappears on con once document
1824 E. Main
1
(Numberand Street)
Address (Number and Street)
ZP147re's
ersbur 567
Petersburg IN 47567
E -mail
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS HIS PROPERTY. IDENTIFY ALL OF THO TAPPLY.
YES NO CONDITION YES NO CONDITION
✓ ❑ 1. Will this property be the buyer's primary
❑
Iq
2 ❑ 3. Homestead
residence? Provide complete address of pri ry
oar •nergy Heating /Cooling System
residence, including county:
❑ ❑✓ 5. Wind Power Device
130 W QhprcySt
❑ ❑✓ 6. Hydroelectric Power Device
Address (Number and Street)
Oakland City, IN Gibson
❑ [Z] 7. Geothermal Energy Heating /Cooling Device
❑ ❑ 8. Is this property a residential rental property?
City.sm e11 a County
❑ [2 Does the buyer have a homestead in Indiana to be
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
below. Please see instructions for more information.
including county:
Not available in all counties.)
///777
q� i� /a ,r �(0. zla —oO�
ta U(/ / -/
Address (Number and Street)
C,y State ZlPCode county
Primarypraperry owner conmc[name Email
Primary
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 in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act". (Note:
Spouse iOrmation, Social Security and Driver's License /Other numbers Ye not necessary if no Homestead Deduction is
be'
Signature ofBtiye naNre of Buypovse
n2(o41zo11
I. 0 1041 n11 any A Hynaman
!pf)T.�ty " ^T ^^ n Dafe(MM/DD/YYYY) Printed al Na eofBuyer 2 1Spouse *n Data(MMIDD/YYY11
Last5Digitsof5ocial Security
License /ID /Other Number Number License /ID /Dther Number