Homestead_Weber (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Sherri S Hudson Closing Manager
Preparer of the Sales Disclosure Farm Title
501 Main Street, Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville,IN 47708 812-421-4000 sherri.hudson(dieffbosse.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) - ` - ' - - • - - -
RussPl K DPI ong
Seller 1-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
/ kiJ` O SA 64 A R it
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and c plete a K equiredband iiss prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller 0 / Signature of Seller
Russel K DeLong '1 f
Printed Name of Seller Sian Date(MM/o0 Printed Name of Seller Sign Date NA/aafrrm
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-.IDENTIFY-ALL ITEMS THAT APPLY --
Jeremy D.Weber
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
200 N Race Street 41-L Add
Address(Num tre Street) Address(Number and Street)
Haubstadt,IN 47639
YES NO CONDITION I YES NO CONDITON Hen
in ❑ 1.Will this property be the buyer's primary W.I ❑ 3.Homestead NTyqq
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling Syai
R 5 7 w
residence,including ❑ 0 TOR
J 5.Wind Power Device
�ddress(Number and Street) ❑ 0 6.Hydroelectric Power Device
A -Et srA br, 1 N 4 ?L,41 C' 8.DM ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIPCode County [1-,/
❑ cg] 2.Does the buyer have a homestead in Indiana to be ❑ LJ B.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) ds€ —/ n J -dOO_� 62j/— od /
City,State ZIP Cade County t'//,% os/ L/j
Primary property owner ran tart name E-mail