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Homestead_Hubbard
INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1807216 Page 2 "D.PREPARER - - - - Jay D.Walden Attorney at Law Preparer of the Sales Disclosure Farm Tide 202 E.North Street Law Office of Jay D.Walden Address(Number and Street) Company Grayville,IL 62844- 618-375-2611 jdw @nwcable.net City.State and ZIP Cade Telephone Number E-mail ,E,SELLER(S)/GRANTOR(S)` _ - - _ - - E.C.Adams Seller l:Name as appears on conveyance document Seller 2-Name as a ppears on conveyance document 702 E.Haub Street Address(Number and Street) Address(Number and Street) 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 r quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Y e Signature Seller �� Signature of Seller Priam'Mien.,dWMr chin nn.„rV"mnrvvrn Mirror?Alamo"r eniM1r cMJ,n •ruuitnrvvvn F.BUYER(S)/GRANTEE(S)--APPLICATION-FOR PROPERTY-TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT-APPLY ______ _ _1 Shane Hubbard Kristi R.Hubbard Buyer I-Name as appears on conveyance document Buyer 2-Name as appears an conveyance nt� 111rrr 1106 Address Doral Street 1106 DoNumber an -Ey■/(�ED Address(Numberand Street) Address(Number and Street) Mt.Carmel,IL 62863- Mt.Carmel,IL 62863- YES NO CONDITION property buyer's P r1t © ❑ 3.Homestead l BSON .row,I i,AUDIT,R YES NO CONDITION © ❑ 1.Will this be the nma residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 702 E.HAUB STREET ❑ © S.Wind Power Device Address(Number and Street) © 6.Hydroelectric Power Device Haubstadt,IN 47639 NOT APPLICABLE CIry,State ZIP Code County ❑ © 7.Geothermal Energy Heating/Cooling Device ❑ ❑ 2.Does the buyer have a homestead in Indiana to be El © $ 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) I L' ^ K �y�Q Ciry,State ZIP Code 7 6—'9-31 Al 0° coo 74 5 W I County Primary property owner contact name -