Homestead_Ralph •
INDIANt; SALES DISCLOSURE FORM SDF ID: 2013 Page 2
'D. PREPARER
Sherri Hudson Closing Agent
Preparer of the Sales Disclosure Form Title
46SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
dress(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 sherri @swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Jeremy W. Overton Tara B. Overton
Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
202 East Gibson Street 202 East Gibson Street
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
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 as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
/ liQvg4 I 3 Ovrc
gnature of •er Signature of Seller
Jeremy W.Overton (7?/08/7-0/ Tara B. Overton /3
Printed Name of Seller Sign Date( DD/YYYY) Printed Name of Seller Sig D e(MMIDD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Am R. Ralph
Buyer - •. - .s appears on conveyance document Buyer 2-Name as appears on conveyance document
406 E. Plum Street(with Parents)
ddress(Number and Street) Address(Number and Street)
�ostadt, IN 47639 •
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. •
YEV NO CONDITION % NO CONDZION-
❑ ❑ 1. Will this property be the buyers primary ( ® ❑ 3. Homesiead�
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System •
residence, including county:
❑ 0 5. Wind Power Device
202 E Gibson St.
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt, IN 47639 I Gibson
❑ 0 7. Geothermal Energy Heating/Cooling Device
City, state IP Code County ❑ 0 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
tit-vail.bl,. ,,,ell-eeunti
Address(Number and Street)
—19 - 31 - 3oy - 000. 05/-009
City, State ZIP Code County - ••-if owner contact 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
inform ion,7ia %y7c rity and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed.)
atureh uyer ° Signature of Buyer 2/Spouse
WR. F7h 3-& 13
Last 5 digits of Buyer 2 Driver's State Last 5 Digits of Social Security Number
License/ID/Other Number License//D/Other Number \^v,A\