Homestead_Toth INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
•D PREPARER% - .;n . f< .- .-
Ray M. Druley Attorney No.4759-26
Preparer of the Sates Disclosure Form Title
505 N. Church Street, PO Box 146 Law Office of Ray M. Drulev
Address(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 drulevlaw(a�yahoo.com
City,State,and ZIP Code Telephone Number E-mail
E:SELLERS)/GRANTOR(S) < (TH • ..:.. . _ „-.,_,.- - -
Daniel Maikranz Rita Maikranz
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
603 E Park St 603 F Park St
Address(Number and Street) Address(Number and Street)
Under penalties of perjur, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as quire(lr�ry law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller il",,�/n_ry_,(/Ojyztn„�.(f Signature)of5 Seller (/l�/'l,Chljf// /
Daniel Maikranz 1/18/2017 Rita Maikranz_ t/1B/7017
Printed Name of Seller Sign Date(MM/DD/rvn' Printed Name of Seller ; v (MM/OD/YYYY)
lF.'BUYER�GRANTEE(SJ.-'APPLICATION!EOR PROPERTY TAX DEDUCTIONS-IDENTIFY-ALL IT AP
- 'Bnstine Marie Toth 1 - 1 " -
ayer'.-Nam¢ sayy> necieyance document Buyer 2-Name as appears on conveyance document
300 S. Main Street JAN 1 9 2017
Address(Number and Street) Address(Number and Stmt)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION / , __YEq--NO—CORDITIGN-___
ig ❑ 1.Will this property be the buyer's primary ( IS ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ ig
300 S Main Street 5.Wind Power Device
•
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County gy
p TA 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 ❑ fl 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.PI-. • •• '. dons or more information.
Not available in all counties.)
Address(Number and Street)
CR6-15?-- ao.? - doh. 3 7d'-v ).6
Gry,State ZIP Code County
Prinn ypmp ny owner wnun.,u ., ,