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Homestead_Besing (2)
• INDIANA SALES DISCLOSURE FORD? SDF ID: Page 2 :D[PREeARER'7---- -- - -'_-'- - - - - — - --- — - -----� Karen Harbison VP Preparer of the Sales Disclosure Farm Title 803 E State Rd 68 Haubstadt State Bank Address(Number and Street) Company Haubstadt IN 47639 8127685800 kharbisoneesbanc.com City.State,and ZIP Code Telephone Number E-mail :E>SEELER(S)%GRINTOR(S):_-- °° • >' - _s-7.70,1, .... -- ---.... - - ------- - --- --- - Justin L Wilson Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 5539 E SR 64 Address(Number and Street) Address(Number and Street) Francisco IN 47649 Telephone Number E-mail Under pe • .y certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and es • . es : • aw, . - I is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seller Justin L Wilson 05/20/2013 Printed Name of Seller Sian Date(MM/DD/YYn1 Printed Name of Seller Sian Date(M.M/DD/rvYYI FF:BUYFR(SVGRANTEE(S)'E LAPP,h'IGATION!EORtPROP,ERTYrTAX DEDDETIONS II DEN:TIEY!ALILITEMS,THATi'APPIY- T f Dustin P Besing a B pears on conveyance document Buyer 2-Name as appears on conveyance document 8518 S 950 E Address(Number and Street) Address(Number and Street) Elberfeld IN 47613 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. YES NO CONDITION ( 1'E�5N9filU.11_ Q ❑ 1.Will this property be the buyer's primary CO ❑ 3.Homestead] residence? Provide complete address of primary u © 4.Solar Energy Heating/Cooling System residence,including county: ❑ ❑ 905 Fast Walnut Si 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Ft Branch IN 47648 ❑ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Cade County ❑ 1Z 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ El 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information moreinormation. including county: f Not available in all counties.) Address(Number and Street) p City,State ZIP Code Co r_______--belourPfecrsrserirsuctionsfor i5 it -JOV_ o0O. . 7 °l -vim' -mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, e,correct and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Disclosure Act".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is bein= filed.) Signature of Buyer] Signature of Buyer2/Spouse Dustin P Number License/ID/Other Number