Homestead_Halbig (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
WrtguP.ARER-*.C' 153.'eS!ccrW-: > mss. : sL:tlka&s, a a q,i.' -y A_. 3;-=r.aft Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number E-mail
ESELL•ER(SyGRAN:T,ORja� - r'b.°_ii . _:.4.. `'' x..ar ,srBi x?i,n .'VS..t1,-' i - .-":3fai -;
Wesley D Kissinger Erica L Kissinger
Seller l-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
9814 S Joy I one 9619 S Joy I ane
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639 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 complete as required by law and is prepared in accordance w' IC 6-1.1-5 5," eeal Property Sales Disclosure Act".
Se - ( �(G�?�! /1
Signature oJS Cr Signature of Seller
�J
Wesley D .ssinger 1?/13/16 _Erica I Kissinger 12/13/16
Printed Name o Seller Sign Date M.M/DD/YYYY) Printed Name a Seller Sian Date LNM/DD/YYYY)
7F:iBUIIEKVIGRAN�TEE(, ARPLI6ATIONIF012`PROEERTA TAK)EDUET102.1 DENTIF,Yt'ALLIIilaSTFFIAT?'AP. L°Y r >_- �fy{t 'a� '•!
Greg A. Halbig Lori L. Halb'g
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
14101 N. St. Joseph Ave. 14101 N. St. Jospeh Ave.
Address(Number and Street) Address(Number and Street)
l.
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.i ,T
YES NO CONDITION YES NO CONDITION
'VI).
YES '
/
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead �/'04,
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑
9819 S. Joy Lane S.Wind Power Device
Address(Number and Street) n 0 6.Hydroelectric Power Device
Haubstad'IN 47639 Gibson ❑ NI 7.Geothermal Energy Heating/Cooling Device
Ciry State P Code County
❑ 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 ❑ NI 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)
City,State ZIP Code County
CZ—/f., _5 —/6 —ado. O 33 - Dot ci
Primary property owner contact name E-mail