HomeMy WebLinkAboutHomestead_Baumgart INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Christopher E.Carl Settlement Agent
Preparer of the Sales Disclosure Form Title
101 Plaza East Blvd., Suite 102 True Title Service, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-402-6555
City,State,and ZIP Code Telephone Number E-mail
._". _ C-. r_
iEaSEL'L`ER(S)/•GRANTOR(S)i�_ _ . L. -- -- •'- .- _ _ _-_-' ` _ -- ,- _-;
Clinton Krieg •
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
501 E Clark Street
Address(Number and Street) Address(Number and Street)
Owensville IN 47665
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co,lete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
gnature of Seller Signature of Seller
Clinton Krieg 12129/2016
Printed Name of Seller Sion Date(MM/DD/YIYY) Printed Name of Seller Sign Date(M.M/ua/YYn)
FiB , - , 'r . S)'..,=APPLICATIONIPORPROP.ERTYLWDEDUCTIONS IDENTIPY;ALLITEMS;THAT(A PL'Y; i._ __
Rohn A. Baumgart
Buyer l-Name as a••• on conveyance document Buyer 2-Name as appears on conveyance document
Street
Address(Number r and Street) Address(Number and Street) it b
Fort Branch, IN
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APVRO,A, fir
YES NO CONDITION YES NO CONDITION 4G -
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead 0/TO
residence? Provide complete address of pri -• — W Cr • :t •eating/Cooling System
residence,including county: ❑
501 E Clark Street 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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.
502 S. Main Street Not available in all counties.)/ /1
Address(Number and Street) / — /ter _07/0/— 000. /6 r- 01,
Fort Branch, IN 47648 Gibson Ron A.Baumgart
City,State ZIP Code County
Primary property owner contact name E-mail