Homestead_Steckler (2) . `
INDIANA SALES DISCLOSURE FORM
SDF ID: _ Page 2
D:PREARR . - - _ - --
- r •
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,State,and ZIP Code Telephone Number E-mail
E.SELLERS)/.GRANTOR(S)• - -- - — _
Kenneth Pall Allen Debbie Jean Allen
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
111 S Campbell Blvd - 111 S Campbell Blvd
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639 Haubstadt IN 47639
Under pen ies of perjury, I hereby certify hat this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co et ire las `an p epared in accordant vC -1.1- 5,"Real Pro e Sales Disclosure Act".
�I// t„l, Q_�iA--
Sig azure of Seller Signature of Seller
Kenneth Paul Allen 05/12/2014 Debbie Jean Allen 05/17/2014
Printed Name of Seller Sian Date(M.N/DD/YlYY) Printed Name of Seller Sian Date(M.V/DD/YYn1
-.F.BUYER(S)/GRANTEE(S)-=.APPLICATION FOR-PROPERTY TAX,DEDUCTIONSElDENTIFY ALL ITEMSiTHAT APPLY_
Jeremy Wayne Steckler
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
11356S150E FILED
Address(Number and Street) Address(Number and Street) ®1
Fort Branch, IN 47648
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APP Ir}',
YES NO CONDITION I YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead GIBSON COUNTY AUDITOR
residence? Provide complete address of primary ❑ Fl 4.Solar Energy Heating/Cooling System
residence,including county: ❑ El
309 S Vine Si S.Wind Power Device
Address(Number and Street) ❑ 12 6.Hydroelectric Power Device
Haubstadt,IN 47639 Gibson ❑ Fl 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
❑ Q 2.Does the buyer have a homestead in Indiana to be n 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
City State(Number
County as-j Q-31-303 -Ono .330-cc9
Primary property owner contact name E-mail