Homestead_Hancock •
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INDIANA SALES DISCLOSURE FORM SDF ID: • Page 2
D.PREPARER _ .
Karen Harbison VP
Preparer o/the Sales Duelasure Form Tide
803 E State Rd 68 Haubstadt State Bank
Address(Number and Street) Company
Haubstadt IN 47639 812-768-5800
City.State.and ZIP Code Telephone Number E-mail
E.SELLER(S1/GRANTOR(S _
Pamela.I Hancock fka Pamela I Kruger fka Pamela J Newton
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
9894 S 550 W
Address(Number and Street) Address(Number and Street)
Telephone Number E-mail
Un er penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and omplete a5�equjr-.r by law,and 's r repared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller 1\ Il Signature of Seller
Pamela J Hancock VVV���111 08(05/2013
Prin: Sian Date IMII/oD/Ynm) Printed Name of Seller Sion Date(MM/OO/Yn'YI
"..BUYER(S)/GRANTS• )a APPLICATION FORPROPERTY TAX DED
(Pawl THAT APPLY-
Steven D Hancock Pamela4Hancock
Bayer I-Name a - , en on conveyance document (I Buyer 2 home as appears • onveyance document•• . 50 W 98945550W
Address(Number and Street) Address(Number and Street)
Owensville. IN 47665 Owensville_IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO: •ROPERTY. IDENTIF • THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary I 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 11J Molar Energy Heating/Cooling System
residence,including county: TTTTTT
9894 S 550 W ❑ 5.Wind Power D�v'µe � ■
Address(Number and Street) ❑ j 6.Hydroelectric we O
Owensville IN 47665 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County A�l�,,I�C'C q0499pp1�2q
❑ Q 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a reSe1[1Cn iat P41iMI property?
vacated for this residence? If yes,provide ❑ Q 9.Would you like to receive tax stat•men for this
complete address of residence being vacated, property via a-ma o-� r,yfjj!act information
•including county: below.Plea;g,�gg+i t 3 fe ATisuyeiration.
Not evailab e a coup les.
Address(Number and Street)
_0?. 100 o -Oa
City.Store ZIP Ca Code County
o
Primary property owner contact name E-mail
