Homestead_Krueger INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
DPREP.ARER
Ray M.Druley Attorney No.4759-26
Preparer of the Sales Disclosure Form Tide
505 N.Church Street,PO Box 146 Law Office of Ray M. Druley
Address(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 druleylaw(ahvahoo.com
City.State,and ZIP Code Telephone Number E-mail
a - P 1 '– -- - ' - - - - _. . -: _ . - _.
E:SELLERS)/GRANTOR(S) _ _- '
Jay 0 Whitehead Karla K Whitehead
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
412F795S 412E795S
Address(Number and Street) Address(Number and Street)
_
Un r penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and lete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
/ ',iy( 7,�. tZ
' gna Iler Signature of Seller
Jay D Whitehead 10/14/2015 Karla K Whitehead 10/14/2015
Printed Nome of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
I.F.BUYER(S)/GRANTEE(Si-APPLICATION FOR`PROPERTY TAR DEDUCTIONS=IDENTIFY ALL ITEMS THATAPPLY .-
Christy M. Krueger,Trustee
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
7064 Address W Short and Address(NUmberand Street) Address(Number and Street)
Owensville, IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE T.11/S1 APPLY.
YES NO CONDITION I YES,/ NO CONDITION GIRvnA, „
0 ❑ 1 Will
ldenre?property
Provide complete buyer's primary s primary •`- g 3.Homestead ylJf�NrYAll
p p ry n IS 4.Solar Energy Heating/Cooling—Pale
residence,including county: ❑
412E 795 S S.Wind Power Device
Address(Number and Street) ❑ Fl 6.Hydroelectric Power Device
Fort Branch, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Fl 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.
7064 W Short Addition Not available in all counties.)
Address(Number and Street)
Owensville, IN 47665 Gibson 2.4--/ 9 _/ 9 - aco Q7 /, 3 a Q 0.34..
City State ZIP Code County
Primary property owner contact name E-mail