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HomeMy WebLinkAboutHomestead_Rexing (19) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.'P,REPARER R. 2-15 _ _ ____ _— s - - __ ' , _. .S-__s . Karen Harbison _VP Preparer of the Sales Disclosure Form Title 803 E State Rd 68 Haubstadt State Bank Address(Number and Street) Company Haubstadt IN 47639 812-768-5800 kharbison(alesbanc.com City,State,and ZIP Code Telephone Number E-mail `_E.:SELLER(S)fGRANTOR(S) - — Randall E Stunkel Michael L Rexing Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document +P J inkox 20i( Lis-, E. 14ct' 1 Address(Numb Ierpnd Street) Address(Number and Street) A.L..J fttlfr.o„ Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and_compl I e required y law,Land i prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". ��, /aturee)of Seller C Signature of Seller Signature of Seller / d- Randall E Stunkel 06(19/2013 Michael L Rexing 06/19/7013 Pnnted Name ofSeller Sian Date/HM/OO/YYYY) Printed Name of Seller Sian Date LNM/OD/IITuii 'i. ::_I, • , - TEE(S)'CAMA CATION FOR PROPERTYMDEDUC^TIONS=IDENTIFY,AE. ENSTHATWPPLY 4;Zi;t.'=;i_. Eric M Rexing Buyer I-Name•..ppears on conveyance document Buyer 2-Name as appears on conveyance document 3738 SR b8— Address(Number and Street) Address(Number and Street) Haubstadt 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. YES NO CONDITION I NO CONDI S. Z ❑ 1.Will this property be the buyer's primary - 0 ❑ 3.Homestead residence? Provide complete address of primary (r - a. olar Energy Heating/Cooling System residence,including county: ❑ NI 3738 E SR 68 S.Wind Power Device Address(Number and Street) ❑ Q 6.Hydroelectric Power Device Haubstadt IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County Z 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property? 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 a including county: below Please see instructions for more information. 601 W Soybean Lane Not available in all counties.) Address(Number and Street) Ft Branch.IN 47648 Gibson 0/6 ae294 Od_Soo _00/, ?o2-/-Oa91 Ciy Stare ZIP Code County Primary property 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 information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed.) Signature of Buyer] Signature ofBuyer2/Spouse Fric M Rexing 06/19/2013 Number License/ID/Other Number