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Homestead_Ziliak (10) cYt- INDIANA SALES DISCLOSURE FORM SDP ID SDO ID 1797267 Paget D.PREP ' Kimberly A.Lewis Office Manager Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 kim.bti@mw.twcbc.com oiy,State,and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S)- - - ; Mark A.Neumann ����QQQQ ,t Seller 1-Name as appears on ronvelvnte document Seller 2-Name as appears on conveyance document r 100 N.Eileen St. i Address(.Number and Street) Addrec(Number and Street) Haubstadt,IN 47639- n•ry Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and1bt}gf,is true,correct and pie e as requi ed by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales DisEPAure Act". 2_�i, //u„,-.- ;preSi. are of Seller Signature of Seller of A. LIZ U/9A/C/// g--Pa- / Pri.,rM n•__ rrc.r c„n ner Pne•pd” nic✓"r- ,,,,n,re,s',* ,„,l„ `f.BUYF.A(SJ-/Sj2ANTEE(S)-APPLICATION FOR PROPERTY TAX DEDU C el IFY ALL ITEMS THAT APPLY / Zachary Ziliak _ Stefanie D.Gross ame as appears en conveyance document - - `rime as appears on conveyance document 8848 5 100 W 8848 5 100 W Address(Number and Street) Address(Number and Street) Fort Branch,IN 47648- Fort Branch,IN 47648- THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION A NO CONDITIO. © ❑ 1.Will this property be the buyer's primary © ❑ 3.Bane -cad residence? Provide complete address of primary 11 a 4:5o ar Energy Heating/Cooling System residence,including county: ❑ 100 N.EILEEN ST. 5.Wind Power Device Address(:umber and Street) ❑ ❑ 6.Hydroelectric Power Device Haubstadt,IN 47639 GIBBON ❑ © 7.Geothermal Energy Heating/Cooling Device City,State ZIP Cade County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ © 8 Is this property a residential rental property? vacated for this residence? If yes,provide ❑ ❑ 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) r-14 -A7-36 - Od- Lao- o 'V- 616 9 City.State ZIP Cale County Primary property owner contact nonce E-mail