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INDIANA SALES DISCLOSURE FORM SDF ID 26- 2009 - 1000681 Page 2 fl
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DAN L. REEVES
ATTORNEY
PKpurer of the Sala Dadosore Fn,,n
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116 S. MAIN STREET
Addrev (N nnber and gmeo
Company
PRINCETON, IN 47670
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E -mail
E SI :I.LER(S) /GR.A NTO It (S)
DAVID F. GREUBEL COUNTRY AYRE, INC.
Seller -Mane ar q,Wa on ronen'anK darument
Selier - Nnmz,u appran on conrnaeee dacumzn:
2282 E. WARRENTON ROAD
Add,. (Atnnt r uul Strewn
Address r 'umber nn, sl ®,o
HAUBSTADT, IN 47639
Ciro. 'r e, and LP 0&,
Ctn_•. Stolz. and ZIP C.1,
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TelephareNumhn E -marl
rider pe talties o et jurv. err certi this Sales Disclosure, to the best of my knowledge and belief, is true; correct and
omplete is qu red t • I a d pre n accordance with IC 6- 1.1 -5.5. "Real Property Sales Disclosure Act ".
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Fil;D- 1'rR(s);, ': N• FEC( s):= :�PfLICA7 :�oN.roR- DEDUCTIONS AND 'CREDITS-- IDeNTIrY;a6l:.19c :its :ftt'1IAPPLV•
JANE E. RASEN
Bvlx +- ,\`,tore as apprar� �' ..omnaru'e Jmmrerrr
Bne - \.:mz ax nppran on rom'na.uz do�rrmenr
DEL ROAD
AJdrev rh'umbrr and Snrea
Andres(rN.n, • rind Srreeq
EVANSVILLE, IN 47720
Clo. Store, andZ PC d,
Clo. State, and %J1'Cnk
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Telephone.Yamber E -moil
Telephonm #umber F -moil
1'llE SALES DISCLOSURE FORM ?IAY RE USED "FO APPLY F'OR CE , j_\-DU
DUC-FIORS FO . II IS PROPERTY. ID ENTI IW ALL OF'II IOSE TIIA'I'
r 1. Will this property be the buyers primary residence? Provide c m lete
7 3. 1lomestend
address of primary residence. including county:
oar :nergy Iieating'C'oolina Svstem
506 S. 9TH AVENUE
r S. Rind Power Devine
Addrev INvmber and Sneer/
HAUBSTADT, IN 47639 Gibson
r 6. Hydroelectric Power Device
OAm Score. rind ZIP Code Connro
�— 7. Geothermal Energy ficating /Cooling Device
F 2. Does the buyer have a homestead to be vacated for this residence" If
r S. Is this propem a residential rental propem:'
yes, provide complete address of residence vacating, including counn:
F_ 9. Would you like to recievc tax statements for this property via
e-mail? (Provide contact infonnnrion below. Please see the
13050 ST. WENDEL ROAD
insumcriom fovnore information. Not available in all counties.)
Addrne(Nvmber rind S,,nv
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EVANSVILLE, IN 47639 Vanderburgh
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Cim $m :q./LP Cafe Cavnn'
Rimap proper:v corm, mnrat name E -mnil
Under penalties of perjury, I here y certify that this Sales Disclosure, to the best of my knmyledge and belief, is true, cnrrect and complete as
required by law, and is prepared in accordance with IC 6- I.I -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 being filed.)
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