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Homestead_Baker (5)
INDIANA SALES DISCLOSURE FORD? SDF ID: Page 2 iDT.PREPARER__ V— —_ — ----- Laura Rininger Closing Coordinator Prepare,of the Sales Disclosure Form Title 7820 Eagle Crest Blvd Ste 201 Regional Title Services,LLC Address(Number and Street) Company Evansville, IN 47715 812-759-5555 City,State,and ZIP Code Telephone Number E-mail E SELLERS)/,GRANTOR(S); ,`_ -__ -- -- . _ -- ___ --- - Kelly L Dillon Seller 1•Name as appears on conveyance document Seller 2-Name as appears on conveyance document 18941 Braehurn Dr Address(Number and Street) Address(Number and Street) • Evansville IN 47725 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 ea,uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". %/ 7 A - -// Si. ature• Seer - Signature of Seller Kell (Dillon 12/8/2014 Printed Name of Seller Sion Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/a0/YYYYI ;F:BUYER[S)/GRANTEE(S)' :APPLICATIONiEOR'PROPERTY,TAX.DEDUCTIONS 4IDENTIFY-ALLITEMSTHATAPPLY _ _ Brett D. Baker Jennifer R. Baker Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 4003 E. Deedand Dr. 4003 E. Deerland Dr. Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 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 YES NO CONDITION DEC 10 2014 Q ❑ 1.Will this property be the buyer's primary 12 ❑ 3.Homestead residence? Provide complete address of primary ❑ 0 4.Solar Energy HeatinP/(/oolin s residence,including county: ❑ 0 5.Wind PowerB�t�coN COUNTY AUDITOR 3666 E SR 68 Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Haubstadt,IN 47639 Gibson ❑ 12 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 ❑ 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 instrucdons for more information. 4003 E. Deedand Dr. Not available in all counties.) Haubstadt,IN 47639 Gibson a 00-©0). 91 \-oa4 Haubstadt,IN 47639 Gibson ,.� 10 3-�a ' 3 City,State ZIP Code County Primary property owner contact name E-mail