Homestead_Heseman INDIANA SALES DISCLOSURE FORM SDF ID: 2014 Page 2
D. PREPARER
Rochelle McDonald Escrow Officer
Preparer 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 rochelle @swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Jack W. Penner Joyce E. Penner
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
5542 S SR 165 5542 S SR 165
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 Owensville, IN 47665
Under penalties of perjury, I hereb certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required law d is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
�`"r r"� CQ-6-7 <,---z0
( Signature of Seller/ ) -Signs e-o Iter J
Jack W. Penner S/2-.A Cl Y Joyce E. Penner
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller .0 . /j e271/ Sign Date(MM/DD/YYYY)
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
❑ tit, ill this property be the buyer's primary El ❑ 3. Homestead
residence? Provide complete address of primary u IA 4. Soiartneigyfieating/Cooling System
residence, including county:
❑ El 5. Wind Power Device
5542 South State Road 165
Address(Number and Street) ❑ El 6. Hydroelectric Power Device
,Owensville, IN 47665 i Gibson ❑ El 7. Geothermal Energy Heating/Cooling Device
. State ZIP Code County ❑ El 8. Is this property a residential rental property?
a g• ❑Does the buyer have a homestead in Indiana to be ❑ El 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.
3°10/ /l t mS fed�j j- /) / Not available in all counties.)
Addre s(Number land Street)
7 -I7- b9 - ape -bo(. 3c01-0aJ
✓e 11511 C1 e I e �� " ��� Primary property owner contact name E-mail
City, State ZIP Code County
,