Homestead_Mitchell INDIANA SALES DISCLOSURE FORM SDF ID: 2016 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)
Matthew A. Morgan Shannon M. Morgan
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
110 S Vine St 110 S Vine 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
and complete as required by law, and is prepared in accordance with'IC 6-'1/21-5.5, "Real Property Sales Disclosure Act".
Si atu - of eller /` \ nature of Seller
;tthe A. Morgan / 2/18/2016 Shannon M. Morgan _ 1: 016
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller i ■ Sign b--e(j +l.'/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITE I T T i -• '•
(colt J. Mitchell ' Megan S. Mitchell • ' t -
---, Buyer 1-)Name as appears on conveyance document Buyer 2-Name as appears on conveyance documen
106 Race St 106 Race St
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639 GIBSON COUNTY AUI)ITOP
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YE _
yi ❑ 1. Will this property be the buyer's primary - ❑ 3. Homestead
residence? Provide complete address of primary -7'-_, 121 4. Solar Energy Heating/Cooling System
residence, including county:
110 S V ne St. ❑ 0 5. Wind Power Device
Address(Number and Street) ❑ 121 6. Hydroelectric Power Device
Haubstadt, IN 47639 1 Gib nsonso ❑ 121 7. Geothermal Energy Heating/Cooling Device
City, State ix)
Code County ❑ 0 8. Is this property a residential rental property?
❑ S"-' 2. Does the buyer have a homestead in Indiana to be ❑ 0 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) , 4 _ 19 „3/ -3o3 - 00033$-00?
City, State ZIP Code County Primary property owner contact name E-mail