Homestead_Foster (6) INDIANA SALES DISCLOSURE FORM SDF ID: 2014 Page 2
• D. PREPARER
Kathy Masterson . Escrow Officer
Preparer otthe 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)=PG RANTOR(S)
William K. Poyner Susan J. Poyner
! Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
348E 790 S 348E 790 5
Address(Number and Street) Address(Number and Street)
Ft Branch, IN 47648 Ft Branch, IN 47648
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 ICC 6.1,-5.5, "Real Prose Sal- ''sclosure Act".
ml
P }�/r,j--.... 41)-.. a . --' -it ;t. -1
6goature'ofSeller I 'Signature.of'Seler—"- i
William K. Poyner 11/5/2014 Susan J. Poyner ` �� 11/5/2014
.l Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller LID li Sign"NM/OD/MY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLt
I
Jay Foster /Amy Foster -) J L,
buyer ft-Name as appears on conveyance document uye�'TZ me as appears on co ce P"••"'^^
5c ti -7 9 O S -3�� & 7 q D g v11i UIJTY AUDITOR
Address(N mber and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
W ❑ 1. Will this property be the buyers primary _ ❑ 3. Homestea
residence? Provide complete address of primary `—,❑c EJ 4. Solar eating/Cooling System
residence, including county:
348E 790 S ❑ 0 5. Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
'1Fort Branch, IN 47648 I Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ El 8. Is this property a residential rental property?
❑ P' 2. 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.
`
Address(Number and Street) -
A4 -/9-/9 -,zo it.oo/, a99-o AG,
( City, State ZIP Code County Primary property owner contact name -mail