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Homestead_McGrewINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2 D. PREPARER Peggy A. Conner Title Assistant Preparerofthe Sales Disclosure Form Title - P. ®01 N. Green River Road Suite 140 Trustworthy Land Title Co.. Inc. address (Numberand Street) E -mail E. SELLERS GRANTORS >..;'.. Troy S Baize Christine L Baize Seller 1 -Nome as appears on conveyance document 4315 W. 200 South Setter 1- Name as appears on conveyance document 4315 W. 200 South Address (Numberand Street) Owensville_ IN 47665 Address (Number and Street) Owensville_ IN 47665 City, State and ZIP Code City, State, and ZIP Code Tele hone Number E -mail I Telephone Number E-mail Under penalties of perjury, 1 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 IC 6- 1.1.5.5, "Real Property Sales Disclosure Act ". S(gnatureofSeller S(gaatureofSeller ' Christine L Baize 03/09/2011 Print ,amen Seller Stan Date IMM DD Panted Nome o Seller S "an Dale (MM/DD F UYER S GRANTEE S -A PLICATION. FORPROPERTYTAXDEDUCTIONS- IDENTIFYALLITEMS.THATAPPLY Scott M. McGrew Bvyerl- Nameas oppwrs nveyvnce document Buyer 2- Nome as appears on conveyance document Address (Number and street) Address (Number and Street) "ato ka. N 7666 ySmte ZI Ciry, State, and ZIPCode E -mail Tel m er E -mail THESALES DISCLOSURE FORM MAY BE USEDTOAPPLY FOR CERTAIN DEDUCTIONS FO IS PROPERTY. IDENTIFY ALL OF THOSE T PLY. YES NO CONDITION YES NO CONDITION Q ❑ 1. Will this property be the buyer's primary ❑./ ❑ 3. Homestead residence? Provide complete address of primary eating /Cooling System residence, including county: a 8evc� 106 South West Street ❑ R] 6. Hydroelectric Power Device Address (Number and Street) Patoka IN 47666 Gibson ❑ Q 7. Geothermal Energy Heating /Cooling Device ❑ 0 8. Is this property a residential rental property? City, SmteZIPCOde County Q❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would like to receive tax statements for this vacated for this residence? Ifyes, provide you complete address of residence being vacated, property via e-mail? (Provide contact information including county: below. Please see instructions for more information. 3119 N. 150 West Not available in all counties.) Q Address (Number and Street) Patoka, IN 47666 Gibson q _— �Q�_ - 3�0 '4Ol d Ciry, State ZIPCode Counry Primary property owner contacmame E -mail 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 IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note: Spouse info ation, Social Se ty and Driver's License /Other numbers are not necessary if no Homestead Deduction is being filrj� S(gnmowo Buyerl Signature ofBuyer2lSpouse 03/09/2011 ✓rimed Legal A'ame ofBaner l S(gn Date(MM/DDITYrr) Printed Legal NameofBuyer2 /Spouse S(gn Dole(MM/DD/YYYY) Last 5 digits of Buyer l Driver's State Last 5 Digits ofsocial Security Number Lost 5 digits of Buyer 2 1Spouse Driver's State Last 5 Digits of5ocial Security License /ID /other Number Number License /ID 10ther Number