Homestead_Rathgeber INDIANA SALES DISCLOSURE FORM SDF ID: Pa&ee Z
DSPREPARFR__ ; . 7—
Cesar Berrios Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd,Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
City,Stare,and ZIP Code Telephone Number
E-mail
Karen M Damin
Seller 1-Name as appears on conveyance document Seller 2'Name as appears on conveyance document
401 F Plum St
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
and complete as re cored by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Karen M Damin 0893/2013
Printed Name of Seller Sian Date(Mat/DO/nn) Printed Name of Seller Sian Date(MM/00/FYYt7
... IUYER(S)/G' • 'TEE($) AP,PLICATION.FORPROPERTY-TAXD - 1 5= 1 • F-YALL[TEM]S_THATAPPLY
David R-thee.- • Misty Rathoeber
• e as appears on conveyance document : er2- •. •ppears on conveyance document
5067 E 1050 South 5067 E 1050 South
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt IN 47639
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION /1' NO CONDITION
N ❑ 1.Will this property be the buyer's primary ` tilLastlo ea
residence? Provide complete address of primary ❑ 0 4.Solar Ener e I /C Ih '
residence,including county: ,��.
401 E Plum St ❑ N 5.Wind Power Device
Address(Number and Street) ❑ N 6.Hydroelectric PAtUry2e9413
Haubstadt, IN 47639 Gibson ❑ N 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 ❑ 2.Does the buyer have a homestead in Indiana to be n 0 8.Is this proper esl 4'int roperty?
vacated for this residence? If yes, provide ❑ 0 9.Would at - , off' for this
complete address of residence being vacated, property via a-mail. rovide contact Information
including county: below. Please see instructions for more information.
5067E 1050 South Not available in all counties.)
Address(Number IN 47639 ! w�'/9.5/-�409:1 /6- (09
Haubstadt. IN 47639 Gibson (]f0�
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
mg file i 0 ` I n/
ti t` kte C 1� l ,k1,!\.\ `2" \` ,Oe AL) 9 il,
Signature ofBuyerl Signature of uyer2/S