Homestead_Brewerry
.INDIANA SALES DISCLOSURE FORM' SDF ID: ' Page 2
D.PREP,SRER
Karen Harbison VP
Prepdretu f the Sales Disclosure Form Tide
803 E State Rd 68 The Elberfeld State Bank
Address (Number and Street) Company
Haubstadt IN 47639
E -mail
E. SELLER(S)/GRANTOR(S)
Country Avre Inr
Seller) Nameasappearsuaconveyancedocument
Seller2 Nameas appears on conveyance dorumen[
99A9 F Warrownn Rd
Address rNumber and Street)
Ha, botadt IN 4763q
Address (Number and Street)
Liar State,, and ZIP Cud,
City. State, and ZIP Code
E -mail
Teleahone Number E -mail
Un r penalties of perl r , I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and .c mpletj"as r it by latt, d is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
Signature of Seller Signature of Seller
ti 5 0/
David F e
Printed Name al seller San D e MM/DD/Y1YY) Printed Nam Sian Date (MAUDD/i
F. t S ) - APP LICATIONIFOR <PROPERT-,Y.TAXiDE
NSNDENTIFY: '?ITEMS•THA— UPPLy.Ti
Benson R Brewer tr
Lavonna Sue Brewer
Buyerl - Nameasappea .writer mvdacument
Bayer2 Nameasoppsareo nveyancedacument
at u Dr
2701 Malibu Or
Addressp+um Fran reel)
.. (Numberand Street)
Evansville IN 47725
Evansville 725
City. State. and ZIP Code
E -mail
Telephone Number E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDIT109
I. Will this property be the buyer's primary
I ✓ ❑ 3. Homestead
residence? Provide complete address of prima
I rgy Heating /Cooling System ^dJl
residence, including county:
❑✓ 5. Wind Power Device 1
Fro S tam Aye
❑ ❑✓ 6. Hydroelectric Power Device
Address (Number and Street)
Haubstadt IN =7639 Gibson _
❑ ❑✓ 7. Geothermal Energy Heating /Cooling Device
❑ ❑✓ S. Is this property a residential rental property?
City. State ZIP Cade 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
including county:
below. Please see instructions far more information.
Not available in all counties.)
2701 Malibu Or
-A&-), aT- 1X17
Address (Number and Street)
Evansville IN -7725 Gibson
City, State ZIP Code County
Primary property owner ran mct name E -mail
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 information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
be' f�l$ filed.) 4��
91IjAA
- 1i= 4(�1A ��/�/Iit T.i<1'Lm .i I�AS/ltifi�
Signaure u /Buyerl �1 Signature ofBuyer2 1Spouse
encnn R Brewer 7 I I I o„nnno Q e Brewer
Printed Legal Nameof Buyerl Sign Date fMAl 1D01YYIYI Printed Legal Name ofBuyrr Z /Spouse Sign Date(MM/DDIYYM
l Driver's State Last 5 Digits of Social Security Number Las[ 5 digitsof8uyer2 1Spouse Driver's State Last 5 Digits of Social Security
I-
License /ID /Other Number Number License /ID /ether Number
-
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