Homestead_Douglas (11) i,
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D`PREPARER
_ . . _. . - - ---
• Karen Harbison VP
Preparer of the Sales Disclosure Farm Tide
803 E State Rd 68 Haubstadt State Bank
Aadresi(Number and Street) Company
Haubstadt IN 47639 812-768-5800 kharbisoneesbanc.com
City,State,cum ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)' _ ' - ' -- - . `.
Harley J Pipke Mary L Ripke
Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
Po Bo .s, 413 -'.o-1j '4-7 3
Address(Number and Street) Address(Number and Street)
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".
'�� 3 c1 e,���� S RIp4
Signature ofSeller Signature of Seller
Harley I Rioke 08/2_312013 Mary L Rioke 08/73/2013
Pnnted Name of Seller Sian Date(uM/DO/YYI'YI Printed Name of Seller Sian Date(MM/OO/YYYY)
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NU CONDITION I(MTh YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 3.Homestead •
residence? Provide complete address of primary ❑ [/j i 4.Solar C o S0
residence,including county: ❑ F Wind
10546W550S 5.Wind Pow e •
Address(Number and StrerQ /
❑ 6.Hydroelectric P w De,„t�G,
Owensville. IN 47665 Gibson ❑ 0 7.Geothermal En 'atmg/ poling Device
Cut,State ZIP Code County
lIZI❑ IA 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property esiden ial n operiy?
vacated for this residence? If yes,provide ❑ 0 9.Would you lik tatements for this
complete address of residence being vacated, property3112190$11COMMA12.1121370131ormation
including county: below.Please see instructions for more information.
'I oval ae er a ..
Address(Number and Street)
Ci .State ZIP Code C.imp:
Primary 47 'e$ .- goo - 000- YK8-va-
a'
Primary property owner contact name -mail