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Homestead_Bond INDIANA SALES DISCLOSURE FORM SDI'ID SDO ID 1800850 Page 2 D.PREPARER- - - _ - ._ - : _ • Kimberly A.Lewis Office Manager Prepare:-of the Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 kim.bti@nnv.twcbc.com Guy,State,and ZIP Code Telephone Number E-mail . Gerald G.Smith Seller I-Nome as appears on conveyance document Seller?-Name as appears on conveyance document 1805 Greenfireid Rd. Address(Number and Street) Address[Number and Street) Evansville.IN 47715- Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete a required b law, prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller --'C .!1 Signature ofSeller ,Gear L0 4r- ..S%,-, r.f % - . / PrinrM N^^ rr6ne c:.. .r t•- . ..m'f+ Orin,..4 fl• nrc,l,r v i^Dr',to.,m,•-'n-' F.BUYER(S)"/GRANTEE(S)-APPLICATION:FORPR'P'RTY.TAX DEDUCTIONS-^IDENTIFY ALL ITEMS THAT-APPLY • ; Ryan F.Bond Buyer I-Name as appears on conveyance document Byer?-Name ns appears an convey. ce at tie 1 650 E. 1025 S 1 Address(Number and Street) Address/.Number and Street) Haubstadt,IN 47639- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE YES NO CONDITION YES NO CONDITION GIBSON COUNTY AUDITOR © ❑ 1.Will this property be the buyer's primary © ❑ 3.Homestead residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System residence,including county: El 641 E.EISENHOWER LANE 5.Wind Power Device Address(.Number and Street) ❑ ❑ 6.Hydroelectric Power Device Haubstadt,IN 47639 GIBSON ❑ in 7.Geothermal Energy Heating/Cooling Device City,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 ❑ © 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.) Addresa(A'u,nber and Street) a 1 0-'P C? I City.State ZIP Code County Primary property owner contact name E-mail