Homestead_RussellINDIANA SALES DISCLOSURE FORM SDF ID: Page 7
D,TREPARER
Abbey Moore Escrow Agent
Prepares ofthe sales Disclosure Form Title
D101 N. Green River Road #140 Trustworthy Land Title Co. Inc
Addrou(Number and Street) Company
Evansville IN 47715
E -mail
E. SELLERS GRANTOR S
_ Ca v R_ Maurer
RPth A TPimann nka Rpth A Maurer
Seller ] - Name as appears on conveyance document
ler2 Nome as appears on conveyance
document
SD9530RA. I�IdQen lrk-e.
a�5 4at�h Il,rlAeo
Latt
Address
umberandsmna)
Address umberan Street)
Cio,Statgand ZIPCoda�
E -mail
Telephone—Number 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 asNbry law, and is prepared in accordance with 1(6- 1.1 -5.5 °Re perty Sales Disclosure Act ".
SignawronfSAlor S(gnatureofSeller
Cary R. Maurer 91 PIl0 Beth _A. Maurer 4174110
Ptlnted Nameo seller Sion Dow MM D Printed Name o Seller Sion Date(MM/DD
F,.'BLW4MFS)/GRANLtM - APPLICATIONFOR PROPERTY TAX DEDUCTIONS- IDENTI FY_ ALL ITEMSTHAT APPLY '-
Andrew K. Russell
Buyers -Name assappwn on con ncedocumeat
Buyer 2 - Name as appcors on conveyance document
nve
Address um rand Street)
Address (Number and Street)
van ville IN 47715
ity, State and VP Code
City, State, and ZIP Code
(
Tole hone Number E-mail
I Telephone Number E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO OSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
Q ❑ 1. Will this property be the buyer's primary
0 ❑ 3. Homestead
residence? Provide complete address of primary
nergy Heating /Cooling System
residence, including county:
❑ ❑ S. Wind Power Device
408E Plum
❑ [Z] 6. Hydroelectric Power Device
Address(NumberandStreet)
Haubstadt, IN 47639 Gibson
❑ ❑ 7. Geothermal Energy Heating /Cooling Device
❑ 0 8. Is this property a residential rental property?
City, State ZIP Code County
❑ ❑✓ 2. Does the buyer have homestead in Indiana to be
a
vacated for this residence? If yes, provide
❑ 0 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 for more information.
Not available in all counties.)
0,/,
Address(Numberand Street)
City, State ZIP Code County
Primary property o"erconmct 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
being filed.)
f
tgnamreo vyerl SignatureafBuyer2 /Spouse
Printed
Last 5 digits of Buyer 1 Driver's State Last 5 Digits of Social Security Number LmtS digits ofBuyer2 /Spouse Driver's State Last 5 Digits of Social Security
License /ID /Other Number Number License /!D /Other Number