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Homestead_Dugan (2)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ;DIPREPARER' ., r. C: Elise A Snyder Vice President Preparer of the Sales Disclosure Form Tide PO Box 1111 First Federal Savings Bank Address(Number and Street) Company Evansville, IN 47706-1111 (812)492-8203 Ciry,State,and ZIP Code Telephone Number E-mail LE SELliER(SI/GRANTOR(S) . :-- `' _ Robert W Dugan Seller)'Name as appears on conveyance document Seller 2-Name as appears on conveyance document 524 S 9th Ave 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 c plete as requi d by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". • / Signature of Seller Signature of Seller Robert W Dugan 10/12/16 Printed Name of Seller Sign Dote(NM/DD/YYYY) Printed Name of Seller Sian Date(MM/00/YYYY) - i.Er-BUYER(S)'/GRANTEE(S)`-_-APPIACATION;FOR'.PROPERMTAX.DEDUGTIONSEIDENTIFYAtiLITE*. I. •PL t s Robert W Dugan B-verl France Dusan Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyanc ument 524 S 9th Ave 24 S 9t Ave Address(Number and Street) Address(Number and Street) Haubstadt, IN THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary El ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ ig 524 S 9th Ave 5.Wind Power Device Address(Number and Street) ❑ Q 6.Hydroelectric Power Device Haubstadt,IN 47639 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code 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 ❑ El 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) 6'ea 3-n(0 ash — On?s _ %34-oaf City,State ZIPCode County Primary property owner contact name E-mail