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Homestead_Rexing (19)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 :iD`PREP,ARERTI= ,P'�-''Ta x s ue, xy 'sue --1.—i n-:< 77,51:xw KAREN HARBISON VP Preparer of the Sales Disclosure Form Title 803 E STATE HWY 68 HAUBSTADT STATE BANK Address(Number and Street) Company _HAUBSTADT IN 47639 812-768-5800 kharbison(aesbanc.com Clot,State,and ZIPCode Telephone Number E-mail .. - - —___- . -tr�s-r _ l,.v. .Z-...r, arr.: a !E'$EtitER($)/GRANTOR(S)�.. -::+�rw�'". -"LS✓YT:, ny�Y.�'Y`�',, �- "7---',C"..rw-.�5 ±` �';+ ._._..-'%i ERIC M RFXING Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 3738 E SR 68 Address(Number and Street) Address(Number and Street) 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 6-1.1-5.5,"Real Property Sales Disclosure Act". L-=—r` - Signature of Seller Signature of Seller FRIG M RFXING 04/04/2016/ Printed Name of Seller Sian Date(MM/DD/YYtt) Printed Name o/Seller Sion Date Gls/OD/nn1 ;f BUtER(SV GfailTCE{S gEAT TEl CATIONIF0RPROP:EfilWaTXDEDUCTIONS D DENT!FESL'LIIENISsT ill TWAT?PDWI 11— ."r_ ERIC M REXING CLARA- RFXING P� Buyer I-Name as appears on conveyance document Buyer 2 Name as appears on conveyance document 3738 E SR 68 3738 E SR 68 Address(Number and Street) Address(Number and Street) A� `I SALE,OISCLCONDITIOR•N MAY BE USEDTOAPPLYFOR CERTAIN DEDUCTIONS FOR THIS bP IDENTIFY ALL DITIp,OFT1105E THAT APPLY. CQ0NvI',e 0 El 1.Will this property be the buyer's primary 0 ❑ 3.Homestead gp0/TQ residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System 9 residence,including county: ❑ Wind 3738 E ST 68 S.ll nd Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device HAUBSTADT IN 47639 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 1:1 8•Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 0 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) �/ 0Xo 71-3 -(aL,.3CY-G0/9d3/- D&117 City,State ZIP Code Caunry Primary property owner contact name E-mail