Homestead_Walden INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
eDtFREP,ARERI.�_ -. - '-' 77-7 _i=u_' -.77 .P„ - - -_ 7;_zt - -
THOMAS L. MONTGOMERY GENERAL MANAGER
Preparer of the Sales Disclosure Form Title
101 PLAZA EAST BLVD.,SUITE 102 TRUE TITLE SERVICE. LLC
Address(Number and Street) Company
EVANSAVILLE, INDIANA 47715 812-402-65565 closines(@truetitlein.com
City,State,and ZIP Code Telephone Number E-mail
:E SEI ER(Sl%GRANTOR(Sj t __ u°` "!..".ff •'_";' ` — -"r_, -a: * ''s
RAYMOND NORMAN HARTIG NANCY R HARTIG
e -Na ap rso c ryance docv rr Na e s appearsonronveyance docume
��_ v ufr to • 1O� �I walf e� �fi.
,Addr s(Number�ty/a/tnd Str��h I� 4764 /'I � ress( �u����
Under pens e s • (� e i•� f:t t ales Disclosure,to the best of my knowledge and belief,is true,correct
and com I f%` '! 1 y I , .f ,2• ,ar d i( accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
�i 7 �_s
Sgnature of Seller 7 Signature of Seller _ -i
RAYMOND NORMAN HARTIG 02/ L /2016 NANCY R HARTIG 02/ Z /2016
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/tD/YYYY)
i E.'B UT ER(S I/,GRANTEE(SjwAPELICATI0N(FORI:PRO PERM'sfAkiDEDU ET!0NS=$iDENT,IE AliL7TEMSITHATc° EPLY _ - -,r
SCOTT WALDEN I ent E D
etryvrl-Name as apprs on conveyance document Buyer 2-Name as appears on ron nce
102 N.WALTERS STREET
. Address(Number and Street) ' ' Address(Number and Street)
•FORT BRANCH,INDIANA 47648 APR 0 4 2016
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL CS FaissaTKINIURTY AU DITO R
YES NO CONDITION I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ IN
102 N WALTERS STREET S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
FORT B CH, INDIANA 47648 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State
-0ZIFCode County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 19 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) r) �
SCOTT WALDENI '-Ig-18-303 -te I.18o-C.^0T
City,State ZIP Code County
Primary property owner contact name E-mail