Homestead_Tank INDIANA SALES DISCLOSURE FORM SDF ID: 2015 Page 2
D. PREPARER
Kathy Masterson 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 kathy@swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Joshua S. Seiler Laura C. Seiler
Seller 7 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
706 E Haub St 706 E Haub St
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true,correct
�2,X,
a -complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Real Property Sales Disclosure Act".
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Sign Cure of Seller Sid u of Seller
4- e eller
Joshua S. Seiler 7/15/2015 Laura C. Seiler 7/15/2015
Printed Name of Seller Sign Date(MMIDD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
William P. Tank Tracy E. Tank
))Buyer]-Name as appears on convey�ce ocument Buye2r 2-Name as appears on conveyance document
a",''ess(Number and Street) Address(Number and Street)
itKM' (73Tfro "I / rti 47(2. 1 fi4-m 3S— , , "r /147 LF7(3i
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OFT S HAT A LY.
,yE,s NO CONDITION Y� NO CONDITION �
1.40 ❑ 1. Will this property be the buyer's primary ❑ 3. Homestead ✓U/ ,f�
residence? Provide complete address of primary ❑ El 4. Solar Ener Heatin. Coolirt‘gy Rm r
residence, including county: ((//S-
❑ 0 5. Wind Power78; • t .
706 East Haub Street ❑ E 6. Hydroelectric Powe ski .?
Address(Number and Street) .�
Haubstadt, IN 47639 Gibson ❑ O 7. Geothermal Energy Heattrt �ing Device
City,State ZIP Code County ❑ ❑ 8. Is this property a residential rentf i erty?
❑ A 2. Does the buyer have a homestead in Indiana to be ❑ ❑ 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
0% - /9 Z A 1/40-or OO , 76/069
City,State ZIP Code County Primary property owner contact name E-mail