Homestead_Strunk INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
PRETARERtx _ : - zt- - :'3'rt7
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 8127685800 kharbisont@esbanc.com
City,State,and ZIP Code Telephone Number E-mail
LE:SELLERS)%GRANTOR(S)i r F_.-.-. - yam.. t. . � ' ..
EMMA 1 011 MCATEE
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1331 PARK 1 ANF
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a• e complete as re a uir•d by law,.. • i pre•:red in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
ff /. ill. 71 1 JI L&
Signature of .ler . Signature of Seller
EMMA1 011 MCATFF DEBBIE EH! ING ATTOR 05/31/2016
Printed Name ofSeller Sian Date theM/DD/YYI'Y) Printed Name of Seller Sian Date(MM/PD/YYY1)
(SjtfAPPCICATION,FOR'tP,ROPERTtYt,TAXWEDUCTIONS9IDENTIEWALL ITEt�1SpTHAT=APP.EYr- l
SHELIA K STRUNK )
t- asap a conveyance document Buyer 2-Name as appears on conveyance document
415 W COLLEGE
Address(Number and Street) Address(Number and Street)
V
YES NO CONDITION }
V
❑ 1.Will this property be the buyer's primary I [i ❑ 3.Homestead N1/2NTy
residence? Provide complete address of primary -LJ 0 Molar Energy Heating/Cooling Sy
residence,including county: ❑ TOR
1811 OUTER LAKE RD S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
PRINCETON. IN 47670 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Cade County
❑ 0 2.Does the buyer have a homestead in Indiana to be 0 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)
- / - -Gb/. .3ei9L Dol 2
City,State ZIP Cade County
Primary property owner contact name E-mail