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Homestead_Wizbacher
— .../ T INDIANA SALES DISCLOSURE FORM SDF ID: _ - _ _ Page 2 D.-PREPARER • _= t,-. • ,.., _.. .. . Karen Harbison VP Preparer of the Saks Disclosure Form Title 803 E State RD Elberfeld State Bank Address(Number and Street) Company Haubstadt,IN 47639 8127685800 kharbison(alesbanc.com City,State,and ZIP Code Telephone Number E-mail E.SELLER(/GRANTOR(S) • - The Avonne Wibbacher Trust U/A May 11 1994 as amended and Avonne Wilzbacher Trustee Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document Avonne Wibbacher as to her life estate interest 525 West 1200 S 525 West 1200 S Address(Number and Street) Address(Number and Street) Haubstadt IN 47639 Haubstadt IN 47639 Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and Iplete as required npbylaw,and is prepared in accorda(nyce . h,IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signam of Seller ' Signature of Seller ej,The Avonne Wibbacher Trust 06/18/2012 AvonP Wilzbacher Trustee 06/1812012 Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DO/YYY11 F.-BUYER(S)/GRANTEE[S) APPLICATION-FOR-PROPERTY TAX DEDUCTIONS:4 IDENTIFY ALL ITEMS-THAT`APPLY . "'``.` - Aaron G Wilzbacher Natalie M Wilzbacher Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document _500 E Strain St 500E Strain St Address(Number and Street) Address(Number and Street) Ft Branch IN 47648 Ft Branch, IN 47648 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 YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary El ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: , 118 S Weber Dr ❑ IS 5.Wind Power Device Address(Number and Street) ❑ Q 6.Hydroelectric Power Device Haubstadt IN 47639 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County IZ ❑ 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 ❑ 171 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. 500 E Strain St Not available in all counties.) Address(Number and Street) Ft Branch. IN 47648 Gibson City.State 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.) I I ) //% `/.1/1� �I ' t Signature ofBuyerl Y S nature of Buyer2/Spouse o Aaron G Wil7hacher 06/18/2012 Natalie M Wil7harher 06/18/2012