Homestead_Gansman INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
fD P,REPARER�° 7.- s7.,_ ,' .. - _ r -
CHRISTINA LENFERS CLOSING AGENT
Prepare,of the Sales Disclosure Form Title
501 MAIN ST STE 101 BOSSE TITLE CO
Address(Number and Street) Company
EVANSVILLE IN 477708 812-421-4000
City,State,and ZIP Code Telephone Number E-mail
E:SELLERS GRANTOR S . . - - 1 . r:1.----.__I r--, - - {. r.':
DENNIS N CONNER GI ENDA J CONNER
Seller I-Name as t wears on conveyance document. Seller 2-Name as appears on conveyance document
1127,'7 1X C �- a SAME
Addr (Number and Stree) / 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
and omplete as required by law,and is prepared in accordance with I 6-1.1-5.5,"Real Property Sales Disclosure Act".
--,''.. li y/• of
Signature of Seller Signature of Selle'
DENNISN CONNER 06/10/2016 GLFNDAJ CONNER 06/10/2016
Printed Name of Seller Sian Date(MSC/DD/YYIY) Printed Name of Seller Sian Date(M.M/DDMYY)
'FTBUYER(S)/GRANTEE(S)'._APPLICATION_FORPROPERTYCTAX-DEDUCTIONSrJDENT(P A f' EM • APPLY__ ._-__:
JEREMY D.GANSMAN DANA MINNETTElµG.{AN
Buyer I-Name as appears on canveyance document Byer 2-Name as appears on can n
613 GREENLEAF DR SAME
Address(Number and Street) Address(Number and Street)JUN 1.4 2016
THE SAL DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPER I ' a •LL OF THOSE THAT APPLY.
YES NO CONDITION ':. NO CONDITION
❑ 1.Will this property be the buyer's primary y ❑ 3.Homestead
residence? Provide complete address of prima . = in- •. -, . nergy Heating/Cooling System
den e,includin un
!1U r f,; � g ty' ❑ Re./6.Wind Power Device
Address(N erandSnet) ,� Tic I(0� 6, Le_ ❑ Hydroelectric Power Device
ft- LV e---P-k. -t / O tLoa-,..n� 7.Geothermal Energy Heating/Cooling Device
City;State ZIP Code County (--��
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ Ld Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 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)
a(„- 19-0 f- (/:3O -OGD. 9(C- o elc City;State ZIP Code County
Primary property owner contact name E-mail