Homestead_Ireland INDIANA SALES DISCLOSURE FORM SDF ID: 26 - 16 - 1098153
Page 2
(DP,REPARER[.-Xt .m�... _ I -'-___t_,.., ""- ±:—.: ::7
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Lacey Pemberton Mortgage Operations Manager
Preparer of the Sales Disclosure Form Title
PO Box 126 LNB Community Bank
Address(Number and Street) Company
Lynnville, IN 47619 812-922-3231 Iemberton@Inbcorp-com
City,State.and ZIP Code Telephone Number
E-mail
lE SELLER(S)%GR'ANTOR(S]li-: -`,----t.i ct-n -::7" i1,164-7-17,77. ' :;t r.: .Tl—sa :3.; .t. , , w i y' z.
Dennis Swader -
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
707 Roosevelt Dr
Address(Number and Street) Address(Number and Street)
Ft Branch, IN 47648
Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as regeuirreed�law,and is prepared in accordance with IC 6-1.1-S.S,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Dennis Swader I'_q_1 DD1 .,
Printed Name of Seller Sian Date(Y.M/DD�/11») _ Printed Name of Seller Sian Date1,414/DD/YY11)
tFt,BUYER(SXGRANTEE[S AP,P:LICATIONtF,ORTROP.,ERT,YTAXiDEDU&TIONS IDENTIF,Y?lal;ITEMSITHAT''AP.P,CY[ .7r, -7.277.79
Brianna N Ries Evan R Ireland
Buyer I-Name as appears on conveyance document Buyer 2•Nome as appears on conveyance document
5080 E SR 168 5080 E SR 168
Address Branch, IN and Street) l Branch
, IN rand Street) �J�
YES NO CONDITION I YES NO CONDITION
m ❑ 1.Will this property be the buyer's primary m ❑ 3.Homestead GIBBON CO AUDITOR
residence? Provide complete address of primary ❑ m 4.Solar Energy Heating/Cooling System
residence,including county:
5080 E SR 168 ❑ 0 5.Wind Power Device
Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device
Ft Branch, IN 47648 26 7.Geothermal Energy Heating/Cooling
Ciry,State ZIP Code County ❑ m gy Device
❑ m 2. Does the buyer have a homestead in Indiana to be ❑ m 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ m 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.) h t
Address(Number and Street) 10-19-13 ab t -ODI,O 15-ba g
Brianna N Ries brianna.ries @yahoo.com
City,State ZIP Code County
Primary property owner contact name E-mail