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Homestead_Elpers (16)
• INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 -0:PREPARER - — Karen Harbison VP Preparer of the Sales Disclosure Form Title 803 E State Hwy 68 Haubstadt State Bank Address(Number and Street) Company Haubstadt IN 47639 812-768-5800 kharbison @esbanc.com City,State,and ZIP Code Telephone Number E-mail iE:SELLE$(S)fGRANTORS Rnhert Aushrooks Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 207 S West St Address(Number and Street) Address(Number and Street) Under pens ties t r erjury- 1 here. • ify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co. sue[ e u - . a .rid Is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seller Robert Ausbrooks 03-30-7015 Printed Name of Seller Sian Date[mai/DO/MYYl' Printed Name of Seller Sian Date IMM/DOM'M F.BUYER(S)7 GRANTEE(S)=APPLICATION!FORPROPERTYTAX_DEDUCTIONS_IDENTIFY-ALLITEMSTHAT APPLY_Cheryl R Elpers Buyer!-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document, 231 E 1200 S •_ 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 THATee • CCJJ YES NO CONDITION YES NO CONDITION rI/l "j:6• ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead qG residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling%6em residence,including county: ❑ Wind OO,Q 207 S West St S. nd Power Device Address(Number and Street) ❑ 6.Hydroelectric Power Device Haubstadt IN 47639 Gibson ❑ V) 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County 111 Q 2.Does the buyer have a homestead in Indiana to be ❑ 0 $•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.) Address(Number and Street) CO City.State ZIP Code County• /u P- ,36- V �• /d - W 9 Primary property owner contact name E-mail