Homestead_Greubel (11) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER .
DANIEL A. MOON ATTORNEY
Preparer of the Sales Disclosure Form Tide
116 S.MAIN ST. REEVES,COCHREN&MOON
Address(Number and Street) Company
PRINCETON, IN 47670 812/385-8641
City,State,and ZIP Code Telephone Number E-mail
:E.SELLERS)/GRANTOR(S) -_ - .
COUNTRY AYRE INC •
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2282 F WARRFNTON FM
Address(Number and Street) Address(Number and Street)
Under t •nalties of perjury,11-reby certify tb. this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co 'plete as r;,;,. -d •y Y.w,and is t re ed in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
At Jr.. .,. ✓
•r.no e of Seller Signature of Seller
01 IC, ' r.eu /el /. " -.5' La
Printed Name of Setter Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F.BUY : . • v • - • • • w• . • I • • : I PERTY TAX DEDUCTIONS-IDENTIFY ALL �T A/jP6Y •
David F.and Maureen B.Greubel Revocable Livina Trust
Buyer 2-Name as appears on conveyance document
2282 E.Warrenton Road DEC 5 2016
Addres(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION FFiO. .
IN ❑ 1.Will this property be the buyer's primary 1%1 ❑ 3.Homestead
residence? Provide complete address of primary ' ❑ U 4.Solar Energy Heating/Cooling System
residence,including county: ❑
S.Wind Power Device
Address(Number and Street) ❑ 151 6.Hydroelectric Power Device
City, ZIP Code County ❑ 0 7.Geothermal Energy Heating/Cooling Device
0 ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 &Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 151 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: belo •r more information.
2282 E.Warrenton Road Not available in all counties)
Address(Number and Saeet)
HAUBSTADT IN 47639 GIBS• • 624-2 3 - i b _ ,too - 000 •3 9S-o..
City,State ZIP Code ...,
.5-o.- owner contact name E-m•'