Homestead_Conrad INDIANA SALES DISCLOSURE FORM SDF ID: 2014 Page 2
D: PREPARER
Teresa S. Holifield 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 teresa @swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)I GRANTOR(S)
Barry W. Money Dori L. Money fka Wagner
Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
995E 925 S 995E 925 S
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
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./11-y5.5, "Real
,Pro eerttyy Sales Disclosure Act".
I _ Signature of a - �—Signature of Seller '
Barry W. Money 6/24/2014 Dori L. Money fka Wagner/ 6/24/2014
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Darren M. Conrad Tami L. Light
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
734 E Eisenhower Rd 734 E Eisenhower Rd
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. IDEN A APPLY.
YES NO CONDITION YES NO CONDITION
5 ❑ 1. Will this property be the buyer's primary 2 ❑ 3. Homestead JUN 2 6 2014
residence? Provide complete address of primary ❑ p 4. Solar Energy Heati g/Cooling S to
residence, including county:
❑ 0 5. Wind Power Dev.
995 E 925 S TY AUDITOR
Address(Number and Street) ❑ 0 6. Hydroelec®tB&OWr OWN
(Fort Branch, IN 47648 i Gibson ❑5 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 5 8. Is this property a residential rental property?
❑ 0 2. 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) a q-200 - 001 .91:)1 - cQS
� - Iq- a
City, State ZIP Code County Primary property owner contact name E-mail