Homestead_Maurer (5) INDIANA SALES DISCLOSURE FORM SDF ID: 2016 Page 2
D. PREPARER
Kathy Masterson 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 kathy @swinland.com
City,.State,and ZIP Code Telephone Number E-mail
[E._SELLER(S)7 GRANTOR(S)
Evan D. Kohl
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
115 S Weber Dr
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 cq/nplete as required by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
_fir SY
f Signature of Seller Signature of Seller
Evan D. Kohl 8/25/2016 8/25/2016
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
,F. BU YER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Ca R. Maurer 1[61' yp9 7q1 ppW--�'
- - appears on conveyance document Buyer 2-Name as appears oR-convayar0e9osOrneht
-?�-If -Dc V-).6 $ H-tcflSV LR `
Address(Number and Street) _ /7 r Address(Number and Street) bLN 1 LUlb
Ceanbville, IN 47&
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
I NO CONDITION � NO • '• e•
❑ 1. Will this property be the buyer's primary 7"" ❑ 3. Homestead
residence? Provide complete address of primary i❑ 0 4. Solar nergy Heating/Cooling System
residence, including county:
❑ 0 5. Wind Power Device
115 S Weber Dr. ❑ 0 6. Hydroelectric Power Device
Address(Number and Street)
Haubstadt, IN 47639 1 Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
�
address of residence being vacated, including county: below. Please see instructions for more information.
9T�J-6 S 11 1 N\E-n/ ( /21( L-e Not available in all counties.)
Address(Number and Street) /�l /
F l j''3)Zi4v fr( /✓ `f I (r.v-Y A6,— 1 8 . 36 - yo y -coo 0 73 - co 9
City,State ZIP Code County Primary property owner contact name E-mail