Homestead_StockonIIVUTANA JALtJ UIJI.LUJUKt YUKM SUF IU: Pa e 2
D:PREPARER
Sherri S Hudson . Closina Manaqer
Preparero(Ih.e Sofa Disdasure Form Title �
501 Main Street. Suite 701 Bosse Title Comoanv
Address (8'umber and Sveet) Campany
Evansville. IN 47708
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E: SELLER S GRANTOR S
Chad Dix
Seller 1- Nome as appears on conveyvnce dacument Sclfer7 � Name as appeors am m�ve}vnre dxumen[
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Address (A'unmber and SveetJ (� Address (i1'umber and StrreQ '
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Ciq'• Smce, and ZIP Code Ciry, Smre, and ZIP lode
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Under penalties of perjury, 1 hereby certlfy that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
an� 5pp�te as_ repuired by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Discl.osure Act".
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Signa[ure of5eller c Signamre o(SCller ,
Chad Diz � I � � �J �
Pnnt¢dNameo Seller SiUnDotelMY/ UD l'Y) PrintedA'omea Sellr� �Sion�ate(FLN DD/F'i'YY�
F. BUYER S GRANTEE S- APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
Breanne M. Stockon Chase A. Stockon '
Buyerl-Nameasappearsomm�veyoncedocument Buyer2-Nomeasappeorsonrom�eyvn cu n[ �
2449 E Classic Dr 2449 E Classic Dr
Address(NumberondStreet) Address(NUmAcrond5trret) NOV 1 2�2015
Haubstadt. IN 47639 Haubstadt. IN 47639
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THESALFSOISCLOSUREFORMMAYBEUSEDTOdPPLYFORCERTAIYDEDURIOHSFORTHISPROPERTY. LLOFTHO APPLY. �
}'FS NO COYDITIOY 'FS NO CO
Q� 1. Will this property be the buyer's primary �� 3. Homestead y
residence? Provide complete address of prima . ar � nergy Heating/Cooling System
residence, including coimty: �
� Q S. Wind Power Device
Addrea(A'umberandStree[) � ❑✓ 6. Hydroelectric Power Device ;
❑ Q 7. Geothermal Ener� Heating/Cooling Device
Ciry, Smre ZIP Cade Counry
X� � 2. Does the buyer have a homestead in Indiana to be � � 8• �s this property a residential rental property?
vacated for this residence? I(yes, provide ❑ �✓ 9. Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail? (Provide c'ontact information
including county: below. Please see instructions for more in�ormation.
�� �� Ci �� 000 E Not available in all counties.J �
dddrrss (A'umberand Svicet)
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cry, sm�e vP eode eo��ry .
Primary properry owner conmct name E-mail
Under penaltles of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6•1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
beri�g filed.) � �� n � ;
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Signamrea(9uyerl Signam�eo(Buyer2/Spouse �
Breanne M. Stockon �� I bV/%��� Chase A. Stockon �J ��/dli!!�
license/ID/OtherNum6er Number Litense/l�/OIheM'umber