Homestead_Schmitt (24) 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)
Julie Michelle Hart
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
200 S 6th Ave
Address(Number and Street) Address(Number and Street)
•
Haubstadt, IN 47639
Under penalties of perjury,by law, accordance Disclosure,to the best, ea I s ' re true,correct
and/¢omAp/let/e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Rea o Sal 1s los re Act".
/Signature of Seller I
Signature of Seller MAY 1 S 2016
lie Michelle Hart 5/12/2016 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 AatatiggicT APPLY
Larry J. Schmitt Susan L. SchmittC'tBSON COUNTY AUDIT Ok
,.1-Na e as appears on conve ance document Byer 2-Name as appears on nveyance documen `
C� _ "N.F 1 11n( I (� Si-. 0()� �l 11 r�,n /�.
Addles tuber and Street —�7
Address'(N ber and
• IN I r /�
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDU - • S FOR THIS PROPERTY. IDE TIFY ALL OF TH THAT APPLY.A YE NO CONDITION YES NO CONDITION
❑ 1. Will this property be the buyers primary . ❑ 3. Homestead
residence? Provide complete address of primary • - • Solar Energy Healinn/Cn ' ystem
residence, including county:
200 S Sixth Ave. ❑ l 5. Wind Power Device
Address(Number and Street) ❑ 6. Hydroelectric Power Device
rHaubstadt, IN 47639 1 Gibson ❑ 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County ❑ k 8. Is this property a residential rental property?
I I: 2. Does the buyer have a homestead in Indiana to be ❑ k7 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete Y� property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
P8 CLJ.Sr p;,, 81.
Not available in all counties.)
Address(Number and Street)
G'oseyP;//E ;.LN. V2633 �(0—I `� / Von t�no. (�io 1�S
City, State Zl Code County Primary property owner c a t name E-mail