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Homestead_Meyer INDIANA SALES DISCLOSURE FORM SDF ID: 2014 Page 2 D. PREPARER Kathy Masterson 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 kathy@swinland.com City, State,and ZIP Code Telephone Number E-mail E:--SELLER(S)I GRANTOR(S) Clinton J. Campbell Seller I -Name as appears on conveyance document Seller 2-Name as appears on conveyance document 7284 S 450 W Address(Number and Street) Address(Number and Street) Owensville, IN 47665 , Under p lties of p rjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct and co e s r Ir by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". Xn of ellea1 Signature of Seller Clinton J. Campbell 9/12/2014 9/12/2014 Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) F.'UYER(S)/GRANTEE(S).-.APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY Zachary L. Meyer . _ :S buyer r-,varne as a pears on conveyance document Buyer 2-Name as appears on o ve j.n ! do,u j en, ,/' 107 N Jeremy Lane Address(Number and Street) Address(Number and Street) SEP 15 2014 Haubstadt, IN 47639 • THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YE tM19N 0 ❑C1'. Will this property be the buyer's primary Pl ❑ *3'"Homestead residence? Provide complete address of primary ❑ 0 4. So ar nergy Heating/Gooling System residence, including county: ❑ 0 5. Wind Power Device 7284 South 450 West Address(Number and Street) ❑ 0 6. Hydroelectric Power Device !Owensville, IN 47665 I Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device City, State IP Code County ❑ 0 8. Is this property a residential rental property? ❑ 4 E2. 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. 'to 'wale. et . Address(Number and Street) •2 (0• /8-/10 .300 -o0/-s`/(o -o J- / City, State ZIP Code County Primary property owner contact name --mail ;