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Homestead_Lannert INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 P.'PREPARER . }. : • Roberta S.Dunlap Attorney at Law Preparer of the Sales Disclosure Form Title 122 N.Saint Joseph Avenue Dunlap&Nesmith, LLC — Address(Number and Street) Company Evansville, IN 47712 _ _ _ 812-402-9970 rdupeC;(@dunlapnesmith.com City,State,and ZIPCode Telephone Number E-mail E.SELLER(S)/GRANTOR(S) - - - 4 A Tamara S Rexing Seller I-Name as appears on conveyance document Seller 2-Name as apers on conveyance document 1246E 900 S Address(Number and Street) Address(Number and Street) Ft.Branch. IN 47648 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 require by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". ,, akthnetaka_ As Signature of Seller Signature of Seller Tama(a$. Rexirlq_ 09/16/2015 Printed Name of Seller Sian Date(M.M/DD/YYYY) Printed Name of Seller AA � �i ;n Date DIMIDD/YYYI) F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AETIMSi THA1�fIP•,',, ichael A. Lannert gg 1166.. uyer I.Name us uppers on conveyance document Buyer 2-Name as appears on tonveyagccdo cement 1921 Euclid Drive UU 1 3 2015 Address(Number and Street) Address(Number and Street) Evansville, IN 47714 i • !,_;si THE 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 17] ❑ 1.Will this property be the buyer's primary I ❑ 3.Homestea residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ IN 5.Wind Power Device Address(Numbe r and Street) ❑ 0 6.Hydroelectric Power Device City,State ZIP Code County ❑ Z 7.Geothermal Energy Heating/Cooling Device ❑ 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 ❑ Rl 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) AC, -/q, 01.9 - ,ono - 00 ). .30,5-0 .5 City,State ZIP Code County Primary property owner contact name E-mail