Homestead_AlstonINUTANA SALES UISCLOSURE FORM SDF ID: P3 C 2
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Karen Harbison VP
Preparer o(rhe Sala Disdasure Form Title
803 E State Rd 68 Elberfeld State Bank
Addrgs (Nvmber ond SveetJ Company
HaubsfadtlN 47639
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Detx�rah Daily Revocahle Trust dated February 3. 1999
Seller }- Name as appears on ranveyanre dacvment Seller 2- Nome as appevrs w cwveyanre documen[
851 Blue Ridge Rd
Address (Nvmber and Stree:) Address (Number ond Street)
Evansville IN 47714
Liry.Smce, ondZlP Code Ciry, Sm[G andZlPCode
E�mail Tele honeNumber E'-mail
Under penalties of perjery, I hereby certlfy that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple[e as required�b law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[".
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Signature of5eller Signamre oj5eller
Deborah K Daily. Trustee 09127/2012
PnntedNameo Seller Si nDate HM 00 Pn"ntedNameo Selfer Si nDace MM DO
_ _ _ _ ' ' _ ' ' _ _ . _ 7 M ' . _ _ � - - . �. � ~c_�'k''
rF'BUXER �S r,GRANTEE �5 �AP.P.LI@ATION€F,OR�P,ROP,ERTY�TAXiDEDUC-T[ONS.� IDENTIF.Y;AIiL ITEMS.THi1T APP:LY.�-�'�+-_«�,,;;��i
ce S Alston Elizabeth K Alsion
., appearsoncmvryanredxumeno Bvyvr2-Nameasappearsonronveyoncedxumena
1482 West 1200 S 1482 West 1200 S
Address (Nvm6er and Svee[J Addra's (Numberand5tree[)
HaubsiadtlN 47639 HaubstadilN 47639
liry. Sm[� and ZIPCode Ciry, Smte, and ZIPCode
Email Tek honeNumber E-moil
TNE SALFS DISQOSURE FOR,tl MAY BE USED TO dPPLY FOR CHRTAI\ DE�UCf10\5 FOR THIS PROPERTY. IDEYTIFY AL6 OF THOSE THAT APPLY.
YFS HO COSDITIO\ � 1'FS '� �^�➢ ON
� ❑ 1. Will this property be the buyer's primary � ❑ 3 Homa�rP�
residence? Provide complete address of primary � � 4. Solar Energy Hea[ing/Cooling System
residence,including county:
700 E Haub St ❑ 0✓ 5. Wind Power Device
Addre[s(Nvmbe�and5vee[f ❑ 0 6. Hydroelectric Power Device
Haubstadt IN 47639 Gibson �j � 7. Geothermal Energy Heating/Cooling Device
Ciry.SmteZlPCode � Covnr� .
❑ � 2. Does the buyer have a homestead in Indiana to be � 0 $� �s this property a residen[ial rental property?
vacated for this residence? If yes, provide ❑ 0 9. Would you like to receive [ax statements for this
comple[e address of residence being vaca[ed, property via e-mail? (Provide contact informadon
including county: below. Please see instructions far more in%rmation.
Not available in all munties.)
Addrts (Nvmber md Svee[J
I a _i4.3t-tioo-oao.�si-oo
[iry, Smte Z/P[ode Coun
E-mail
Under penalties of perjury, t hereby certify that this Sales Discbsure, 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 ecurity and Driver's License/Other numbers are not necessary if no Homestead duction is
bein filedJ
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mm /Buyerl � S�gnaNreo( yrr2/Spause
Rrvra S Akion 09/27/2012 FI"�ahPth K Alcton 0Q/27I7017
PnntedLegal,VameofBvyal SignDa¢[NM/D�/YYl'Y) Pnn[ed alName B/u}
IN
LastSdigicso/BuyerlDriver's Smre LaslSDigitsof5ociolSecunryNum6er Las[Sdigitso(Buyer2/SpouseDriver's Sm[e LastSDigi[so/SonalSecuriry
6irense//D/OtherA'umber Num6er License/ID/OtherNum6er