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Homestead_Schmits4 C r L INDIANA SALES DISCLOSURE FORS[ SDFID SDO ID 714628 Pag D.PREPARER Kimberly A. Lewis Preparer ofthe Seim Decleuvre Form Tide 226 W. Broadway Broadway Title, Inc. Addrms (Number and Stren) Company Princeton, IN 47670- E. SELLERS GRANTOR S Mike R. Vogler Seller 1 Name os app ®rs on conveyance document SellerZ Name os upPearson mnvewnce drcvment �G / t1. S4V7 /✓G- IMP Address(Numberoad Street) ��eS�in� /�f/ Address(Numberand Street) Heebsta9t�- 4;'639- Y7SZ/ Ciq; S:arq and LlPCOde City, Sm[q and 71P Cade E -mail Tele one 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 required by w, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". Jcomplete �as Sig nature a(Selier Slgnamr,efSeller 9 r ERS GRA\ S - APPLICATION FOR PROPERTY TAX DEDUCTIONS-- IDENTIFY ALL ITEMS THAT APPLY Kimberly A. Schmns „ rsa&'e,sm edorvmeat Buyer Z- Name as appears on ronvewnce document 517 N. West St. Address(Numberand Street) Address (Number and Street) Fort Branch, IN 47648 - Chy, State, and ZIP Code City, State, and ZIP Code E- ..mil Telephone Number E -moil THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION Q ❑ 1. Will this property be the buyer's primary Q ❑ 3. Homestead residence? Provide complete address of rimary ergy Heating /Cooling System residence, including county: ❑ Wind 300 S 5TH AVE. 5. Power Device ❑ © 6. Hydroelectric Power Device Address (NumberandSaeeil Haubstadl, IN 47639 GIBSON E] © 7. Geothermal Energy Heating /Cooling Device City, State ZIP Code County ❑ © 8• Is this ❑ ❑ 2. Does the buyer have a homestead in Indiana to be property a residential rental property? 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 for more information. Not available In counties.) - 006e j& & �-t (/v ( /,•f a Addrm(Number and Street) City. Smte ZLP Code County Primary property miner contact name f -mail Under penalties of perjury, 1 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.) S``ig''natureo(BCyerl Signature ofRuv,,21Spome ` �1 (� K .MbQf ILL A 4 I'1M�S lj.�.'111� Punted Legal Name Buya] 2/ Ym S(qn Da:e(MM/ao/1 Punted Lrgal,yameo l ) BuyerS W use Agn Dcle (MU /ooM»7 ��� l Driver's State Lost 5 Digits of Social Security Number Lost 5 digits of Buyer 2 1Spause Driver's State Last S Digits Social Security of License /ID /Other Number Number License /ID /Other Number