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Homestead_Fonte INDIANA SALES DISCLOSURE FORM SOF ID: 2015 Page 2
D. PREPARER
Teresa S. Holifield Escrow Officer
Preparer of the 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 tresa@swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Donald S. Harder _ Annette C. Harder
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
6614 S 325 W 6614 5 325 W
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort 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 IC-6-1.1-5.5, "Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller "
Donald S. Harder 3/12/2015 Annette C. Harder 3/12/2015
Printed Name of Seller Sign Date(MM/DDNYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Whitney Erin Fonte Ryan Parks Fonte
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on con yet ument
3937Es(NS 3937Es(Nm 11pp[[ 1
Address(Number and Street) Address(Number and Street) -,p�_6®r
Fort Branch, IN 47648 Fort Branch, IN 47648 ,
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. •` •'U •1' •I-iy .7 . -'T APPLY.
YES ❑NO CONDITION 1. Will this property be the buyer's primary YES ❑ 3. Homestead OVNTYqu0ITOR NO CONDITION
residence? Provide complete address of primary ❑ E 4. Solar Energy Heating/Cooling System
residence, including county:
❑ El 5. Wind Power Device
6614 S 325 W ❑ El 6. Hydroelectric Power Device
Address(Number and Street)
`Fort Branch, IN 47648 I Gibson ❑ El 7. Geothermal Energy Heating/Cooling Device
(-City, State ZIP Code County ❑ El 8. Is this property a residential rental property?
k'r ❑ 2. Does the buyer have a homestead in Indiana to be ID 9. Would you like to receive tax statements for this
/, vacated for this residence? If yes, provide complete property via-email? (Provide contact information
2 address of residence being vacated, including county: below. Please see instructions for more information.
61"1 q - —0 - Not available in all counties.)
dJdresssl(Number and Street)
V I-, R N A)d k T43 Y)&-1 �' (0, - 26- 1P-I6-/D0043 99Q 0a/
City,
State ZIP Code County Pnmary property owner contact name E-mail