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Homestead_Bauer INDIANA SALES DISCLOSURE FORM SDF ID: 2013 Page 2 D. PREPARER Kathy Masterson Escrow Officer Prepare(of the Sales Disclosure Form Title 605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title Address(Number and Street) Company Evansville, Indiana 47713 (812)425-0055 kathy@swinland.com City, State,and ZIP Code Telephone Number E-mail ItEESELLER(S)-YGRANTOR(S)_—_,y James Czoer dba Czoer Construction - Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document 650 E 1025 S Address(Number and Street) Address(Number and Street) Haubstadt 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 requ- c• by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". /Sign-ureof Salle -"r Signature of Seller t J/{yytc 5 G20t72-- 9/16/2013 9/16/2013 CPiinledName:dfSelle'c Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) E-BU.YER(S)/GRANTEE(S)..ABE'LICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL ITEMS THAT APPLY • Denyse Bauer Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 2701 St. Philip Road S. Address(Number and Street) Address(Number and Street) FILED Evansville, IN 47712 Telephone Number SEP 1 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 YE UNUI `'nf�', 121 ❑ 1. Will this property be the buyer's primary❑ 3. Homestead Tom'Le residence? Provide complete address of primary ��11NTY AUDITOR residence, including county: ❑ 0 4. Solar Energy H�31� �1�rfl�5ysiem ❑ El 5. Wind Power Device 1348 West Chukar Hollow Address(Number and Street) ❑ O 6. Hydroelectric Power Device Haubstadt, IN 47639 Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device City, State ZIP Code County ❑ 0 8. Is this property a residential rental property? ❑ Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this vacated for this residence? If yes, provide complete property via-email? (Provide contact information address of residence being vacated, including county: below. Please see instructions for more information. Not available in all counties.) Address(Number and Street) (0- 718 -3(7-30 0 -0c7d,.s (-poly City, State ZIP Code County Primary property owner contact name E-mail