Homestead_Whitehead INDIANA SALES DISCLOSURE FORM SDF ID: 2016 Page 2
D. PREPARER
Rocksan Underhill 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 rocksan @swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
SPM Development, Inc., an Indiana corporation
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
304 E State Rd 68
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
Under nalties perju, reby,ertify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct
and c plete pr�r 'l flaw, prep in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
1 I Signs tire- Seller KT Signature of Seller
4Sen-irx--\-h ( . `) tejt-1 pdif Ac i447t2016 3/7/2016
Printed Name of Seller I Sign Date(MM/DD/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
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALLL '1•♦ �•' A - ,;PPLY.
YES NO CONDITION YES• NO CONDITION CO(/aI -•'
�❑ ❑ 1. Will this property be the buyer's primary ❑ 3. Homestead �q
/V/
residence? Provide complete address of primary ❑ p q. Solar Energy Heating/Cooling System
residence,including County:
602 W Elm St. ❑ fl 5. Wind Power Device
Address(Number and Street) El a 6. Hydroelectric Power Device
Haubstadt, IN 47639 I Gibson ❑ a 7. Geothermal Energy Heating/Cooling Device
City,Statte/ZID Code County ❑ fl 8. Is this property a residential rental property?
❑ 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 II counties.)
Address(Number and Street)
/_AR j3 - o -ao0. 8L8- 009
City, State ZIP Code County Primary p op ny owner contact name E-mail