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Homestead_Allen (7) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D. PREPARER KELLY HUGEBECK DOCPREP Preparer of the Sales Disclosure Farm Title 4877 GALAXY PKWY,SUITE.I MORTGAGE INFORMATION SERVICES,INC. Address(Number and Street) Company CLEVELAND.OH 44128 888-901-4647 City,State.and ZIP Code Telephone Number E-mail E.SELLERS)/GRANTOR(S) James Allen Seller!-Name as appears on conveyance document Seller a•Name as appears an conveyance document 105 S West St Address(Number and Street) Addres(Number and Street) Fort Branch IN 47646 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co letete as by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Sign re of Seller Signature of Seller 35,7 me s M/ey /04a4i/2G/6 Printed Name a(Seller Sian Date(MM/aa/MT Printed Name of Seller Sian Date(M91/OB/YIYl1 F.BUYERS)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY James Allen THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE Y. 'O YES NO CONDITION YES NO CONDITION 04/ p ❑ 1,Will this property be the buyer's primary IN ❑ 3.Homestead ,9 residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooliine4ydtem residence,including county: ,Q ❑ ❑ -v 705 S West St 5.Wind Power Device Address(Number and Street) ❑ E 6.Hydroelectric Power Device Fort Branch,IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ p 2.Does the buyer have a homestead in Indiana to be ❑ CI 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 12 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(N t0 umber and Street) 2 -/ F - /3-1/03 000 i65 "e). - James Allen City,State ZIP Code County Primary property owner contact name E-mail