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Homestead_McCandless I !..■' INDIANA SALES DISCLOSURE FORM SDF ID: Page D.PREPARER -- - -- ---- - - - - -- - - - : - --- ' 'Karen Harbison VP Preparer of the Sales Disclosure Form Title 803 E State Hwy 68 Haubstadt State Bank Address(Number and Street) Company Haubstadt, IN 47639 812-768-5800 kharbison@esbanc.com City,State,and ZIP Code Telephone Number E-mail E:SELLERGRANTOR(S) - °- -_-- - ---. - --Darwin J Nelson Lillie Fay Fitch Seller I-Name as appears an conveyance document Seller 2-Name as appears on conveyance document 3271 E 50 S 905 S Stout St Address(Number and Street) Address(Number and Street) Princeton IN 47670 Princeton. IN 47670 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 6-1.1-5.5,"Real Property Sales Disclosure Act". X 'CI g N,:-.;— ,/ -4 SigceofSeller if-c.2...., LY2a-4 Darwin J Nelson 09112014 1 illie Fay Fitch 09112014 Printed Nome oi'Seller Sign Date rMM/DD/rryi) Printed Name ofSeller Sian Date(MM/oo/vrn) F.BUYER(S)/GRANTEE(S)-'APPLICATION!FORPROPERTY TAX.DEDUCTIONS-IDENTIFY;ALL=ITEMS THAT'APPLY __ _ - Beuthel P McCandless Diana R McCandless Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1530 N 1220 E 1530 N 1220 E Address(Number and Street) Address(Number and Street) Oakland City. IN 47660 Oakland City IN 47660 TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL 0E71 T YES NO CONDITION I YES NO CONDITION Q ❑ 1.Will this property be the buyer's primary 171 ❑ 3.Homestead SEP 1 2 2014 residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling S stem residence,including county: ❑ TA 5.Wind Power Dee 104 dd es Kensington Dr 6.H droeleQlfit3®CY�ill)M&Y AUDITOR Address(Number and Street) ❑ I� y Princeton IN 47670 Gibson ❑ IL 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County Q ❑ 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 ❑ 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. 1530 N 1220 E //� Not available in all counties.) {/�I� r/�� Andress(Number and street) /YA — I/—id-aDa-tNI •615-UP Oakland City, IN 47660 Gibson (/ 111YYY a City,State ZIP Code County Primary property owner contact name E-mail -