Homestead_Kern •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER -
Stacey Salzman Closer
Preparer of the Sales Disclosure Farm Title
4962 Lincoln Avenue First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 812-490-8485
City,State,and ZIPCode Telephone Number E-mail
Lisa Grub
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
439 South Old State Road 65
Address(Number and Street) Address(Number and Street)
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 co plete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
x0,1 d ,1 ,--
Signature of Seller I Signature of Seller
I isa Grubb 8/19/2014
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/OD/YYYY)
S.BUYER(S)YGRANTEEtSY-APPLICATION FOR PROPERtY TAX DEDUCTIONS-;IDENTIFYALL ITEMS TIIATAPPGX -_° i`` _ _ - ,
Mary ry Beth Kern 1 � -F
— e B mea up ears one veyv a or men 1 Buyer Z-A'ameas appears an ronve}mc�4-- -t jj
0 ress(Number and Str et) Address(Number and Street)
•
Q to f Li-10' Io sEP 18 2014
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.l NTY AUDITOR
YES O CONDITION I YES NO CONDITION
J ❑ 1.Will this property be the buyer's primary ❑ ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
4 1 f eiitL` •�lcy1Ea ,-(1.-1-e vl a r ;5 ❑ 0 S.Wind Power Device
'essssJNumberandStr11eet) 1 (�� '-1 �` ❑ Q 6.Hydroelectric Power Device
r, y IL.O�U t
❑ g 7.Geothermal Energy Heating/Cooling Device
ity,State ZIP Code ` 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 ❑ 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)
14,- 11 -04 3ocs ass3 915Oa7
City,State ZIPCode County
Primary property owner contact name E-mail