Homestead_Meny (16) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER: - _ '?- . - - ;•
Karen Harbison VP
Preparer of the Sales Disclosure Form Title
803 E State Rd 68 Haubstadt State Bank
Address(Number and Street) Company
Haubstadt IN 47639 8127685800 kharbison @esbanc.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)JGRANTOR(SJ:.-=. . • '
ANTHONY D WHITI ER JODI LEF WHITLFR
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
12665 CM DSR65 12665 OLD SR 65
Address(Number and Street) Address(Number and Street)
PRINCETON IN 47670 PRINCETON IN 47670
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 C 6.1.1-5,5,'Real Pcope •Sales Disclosure Act".
Sltivtu ca n. S-22 /S e u� tin. 5�a/S
Signature S Iler r Si aure of;e er
:L ,•k t a2 EC JODI LEE WHITLER
Printed Name of Seller Sian Date(mm/DD/MY) Printed Name of Seller Sian Dare(MM/DD/Y1711
F.BUYER(S)/GRANTEE(S). APPLICATION:PORPROPERTYTAX.DEDUGTIONS IDENTIFY:'ALLITEMS-THA•TAPPLY_____ _ - _
DREW A MENY CAITLIN M MENY
Buyer I•Name as appears on conveyance document Buyer 2-Name as appears on conveyance document •
506 E HAUB ST 506 E HAUB ST
Address(Number and Street) Address(Number and Street) FILED
HAUBSTADT IN 47639 HAUBSTADT IN 47639
TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION Mme•
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead IBSON COUNTY AUDITOR
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 12 5.Wind Power Device
10019 S PARTRIDGE AVE
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
HAUBSTADT IN 47639 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device
cy,State ZIP Code County CJ 0 8.1s this property a residential rental property?
[71 ❑ 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide ❑ 0 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.
506 E HAUB ST Not available in all counties.)
Address(Number and Street)
HAUBSTADT IN 47639 GIBSON Z&- /8•-5L-c3oO Ooa , o/H ea9
City,State ZIP Code County
Primary property owner contact name E-mail