Homestead_Sprinkle INDIANA SALES DISCLOSURE FORM SDF ID: 2015 Page 2
D. PREPARER
Teresa S. Holifield Escrow Officer
Preparer of the Sales Disclosure Fomi Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 teresa @swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)I GRANTOR(S)
Linda F. Hirsch
Seller t-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10133 S 350 E
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct
and comp) as required by law,a d is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
Signature o/Seller / Signature of Seller
Linda F. Hirsch 7?Il
Printed Name of Seller Sign D e(MM/DDNYYY) Printed Name of Seller Si DNYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
- JAN 3U Nl5
' Larry D. Sprinkle 1 Ellen R. Sprinkle
Buyer r -!vilifiers appears on conveyance document Buyer 2-Name as appears on conveyancdocument
603 S Eastview St 603 S Eastview St fl
Address(Number and Street) Address(Number and Street) GIBSON COUNTY AUDITOR
Fort Branch, IN 47648 Fort Branch, IN 47648
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
I7 ❑ 1. Will this property be the buyer's primary .4"---0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System
residence,including county:
❑ 0 5. Wind Power Device
10133 S 350 E
Address(Number and Street) El 0 6. Hydroelectric Power Device
Haubstadt, IN 47639 I Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
k ❑ 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.
(IN S. t- rvlei.J (r7-}. Not available in all counties)
�Address(Number and Street) l��jj f �4 _ 19--31/- (/QQ- oOV. y6S_O�-7
't. ����fN �� 77�� �� � nmary property owner contact name -mail
City,State ZIP Code County \�.