Homestead_Hart INDIANA SALES DISCLOSURE FORM SDF ID: 2016 Page 2
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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)I GRANTOR(S)
Matthew R. Parmer Amy M. Parmer
Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1003 E Elm ST 1003 E Elm ST
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 requi -• •y la d is prepared in accordance with IC 6- 1-5.5, "Real Prop rty Sales Disclosure Act".
ire raralarraellr i /(mot AlV\-Q/l
Signature of Se/!- "s Signature of Setter
Matthew R. Parmer 5/12/2016 Amy M. Panne/ 5/12/2016
Printed Name of Seller 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
Julie M. Hart � �
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears or&odvrta ado t Ltnr■ e
200 S 6th St A1g9 11. gs-J1 L
Address(Number and Street) Address(Number and Street)
Haubstadt,
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. Ian rvtl®o EA Irj Y.
Y NO CONDITION YES NO CONDITION
❑ 1. Will this property be the buyers primary ❑ 3. Homestead
residence? Provide complete address of primary ❑ -fa% 4. Solar Energy Heating/Cooling System
residence, including county:
1003 W Elm St.
❑ b` 5. Wind Power Device
Address(Number and Street) ❑ -IR 6. Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ --111 8. Is this property a residential rental property?
❑
2. Does the buyer have a homestead in Indiana to be
A
El
9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
ad/dre of,residence being vacated, including county: below. Please see instructions for more information.
)66 5 ( /i It Not available in all counties.)
Address(Numb r and Street �1..
/�ljl(h.5 a(/{ /N y71�31 • aCo- l$ 310- f03- COO. ')14-009
City, State ZIP Code County Primary property owner contact name E-mail