Homestead_Grubb Y(DIANA SALES DISCLOSURE FORM SDF ID: _ _ _ Page 2
3y M. Drulev Attorney No.4759-26
' Teparer of the Sales Disclosure Form Title
.105 N.Church Street, PO Box 146 Law Office of Rev M.Drulev
Address(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 drulev(o)insiohtbb.com
City,Statg and ZIP Code Telephone Number E-mail
,_E. EICER(S)/GRANTDI2(S)C - '--- - - -- -,- .-r---- ---_ - -- • t, -----_•
Fstate of Mary Louise Reed
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
308 S fith Avenue
Address(Number and Street) Address(Number and Street)
Hauhstadt 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
a rte complete as required by law,an re ared in accordance with IC 6.1.1-5.5,"Real Property Sales Disclosure Act".
I.
Signature of •le Signature of Seller
It- I" 'r •- :-. I ■ 1
Printed Name of Seller Sign Date(HH/DD/YYYY) Printed Name ofSeller Sign Date DO/DD/MY)
FF!:BUYER(S)%GRANTEE(S); AP,PLI CATtoM-FokPROP.ERwilAYDEDUCTI0N5=(DEN;TIFYALC'ITEMS'THAT.APPCYri- 7 , -":._'
Ronald A. Grubb Patricia A. Grubb
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
2272 E. Presley Drive 2272 E Presley Dr.
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 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 YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ IN 4.Solar Energy Heating/Cooling System
residence,including county: ❑
416 Bradley Drive
5.Wind Pow c
Address(Number and Street) ❑ 0 6.Hydroelec is P v D ce
Haubstadt, IN 47639 Gibson
ciry,StateZIPCode County ❑ 0 7.Geothermal Energy Heating/Cooling Device
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this propert�,J&s$l &l3ental 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- '.il? P.: • y Intact information
including county: below.Pleases'' '1�r .'er information.
g Not avd@7AA�1f1 NdX.� D 6e{2 f
Address(Number and Street) '-1 l(II////�� }� q�
City,State ZIP Code County d) -23 t*-1x3 '000 . 538 -009
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 e \city and Driver's License/Other numbers are not necessary if no Homestead Deduction is
•epgfiled. ) to
Signature