Homestead_Schmitt (20)l,
� INDIANA SALES DISCLOSURE FORD7 SDF ID: Pa e 2
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Kathv Jo Odom Asst Cashier
Preparer o(the Sales Disrlosure Form Title
220 S. Lockwood St.. PO Box 280 CommuniN State Bank of Southwestern Indiana f!k/a CSB State
Address (Nvm6er and SveetJ Company 3anT
Posewille IN 47633 (
E�mail
7E?iSEI'LER S �,GRA\TOR S L+'� .� =-- ' �-=--� :..�., a,h.'�'.���jx`�'.'�''.�`_���iF`.•�.::���'"s�"�._'=.�hr �� ; t,,:�sr,� : �
EstatP or R�ta c s�nm�n �/RRG �iCET /�• NoTT/NG NA/'�
Se71er1-Xameasappearsonronveyvncedocument Seller2�Nameasoppev anronveyvnredxumen(D
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Addres(NumberandSPeelJ �7Address(Numberand5treet) � ?7
Cynthiana IN 47fi19 rO S B-r U/L L�� Li� � ��/ ✓
E-mall
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
an omplete as required by law, and is prepared in accordance �vith IC 6-1.1-S.S, "Real Prope Sales Dy'�} osure A�c[" 7
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namreoJSefler Signotu e (Seller
JosPph M. Schmitt Co-Personal Reorecentative �?l7?Ii? Marqaret M. Nottinflham_ Co-Personal 12129112
Pnn:edNUmeo Seller SionDas HM/OD PrinfedNameo Seller Representa[ive SianDa@ NN/�D
�.Fl�:BUYHR' S `.GR:INTEE 5 �AP,P;liICi1TI0N,F,QRFP,ROPERTY3TAX<DEDUCTIONSsIDENT[F.Y�ALLfITEMSrT�HAT�APP;LY�_,_��;�-�?-;,�
Walter Schmitt
Buyer ]- Name as appears an com�eyance document Buyu 2� Name as appears on conveyvnre dxument
10716 S 550 W
Addres(Numberand5tree[) Address(Numbera�5treet)
_ Cynthiana IN 47612
Ciry.Smu, and ZIPCode Ciry, Smre, and ZIPCode
£-mail Tele honeNumber E�mail
THE SALFS DISCLOSURE FORA1 MAY BE USED TO APPLY FOR CERTAIY DEDUCf10YS FOR THIS PROPHR7Y. IDHM'IFY ALL OF THOSH THAT APPLY.
YES NO CONDITION I YFS NO WNDITION
0✓ � 1. Will this property be the buyer's primary 0✓ � 3. Homestead
residence? Provide complete address of primary � Q 4. Solar Energy Heating/Cooling System
residence, induding county:
io7i6 s 550 W ❑ ❑✓ 5. Wind Power Device
Addrrss(A'umberand5vee[J ❑ ❑✓ 6. Hydroelectric Power Device
Cvnihiana IN a7612 Gibson � Q 7. Geothermal Energy Heating/Cooling Device
Liry.SmteZlPCode Counry
� Q✓ 2. Does the buyer have a homestead in Indiana to be �❑� $• �s this property a residential rental property?
vacated for this residence? If yes, provide ❑ ❑✓ 9. Would you like to receive tax sfatemenu for this
complete address of residence being vacated, property via e-mail? (Provide contot[ informoCion
including county: 6elow. Please see instrucdons for mare in%rmation.
Not available in all counties.)
Addres (Number and Svee[)
d�-zz-o5-�a� �S���a�
Ci.y, Smte ZIPCode Counry
Primary properry ownerconme[ rmme E-mvil
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