Homestead_Nelson (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D. PREPARER
Kathy Masterson Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 kathy@swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
John T.Waggoner Pamela R.Waggoner
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
214S Main St 214S Main St
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660 Oakland City, IN 47660
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best •f my knowledge and belief, is true,correct
andtomplete s required by law, and is prepared in accordance with IC 6=1.1.5.5 Real Property Sales Disclosure Act".
./��F)c �— Al ��
J! nature of eller / ignature of Seller
n T.Waggoner • 2/28/2017 Pamela R. Waggoner 2/28/2017
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Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller �gg� n D� ate(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT
John E. Nelson Wendi L. Nelson
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance documvt
2819 Granfield Ct 2819 Granfield Ct qR 7
Address(Number and Street) Address(Number and Street) 20/7
Evansville, IN 47725 Evansville, IN 47725 G/ 1 .
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.r-/t
YES NO CONDITION YES NO CONDITION
NQ) ❑ 1. Will this property be the buyers primary ❑ 3. Homestead
( residence? Provide complete address of primary ❑ El 4. Solar Energy Heating/Cooling System
residence, including county:
❑ El 5. Wind Power Device
214 S Main St.
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Oakland City, IN 47660 ( Gibson ❑ Z 7• Geothermal Energy Heating/Cooling Device
City,State ZIP Code • County ❑ 0 8. Is this property a residential rental property?
2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes,provide complete property via-email? (Provide contact information
G address of yeside ce being vacated, including county: below. Please see instructions for more information.
Z I fi b- rr. L'�� t- 0-*-- Not available in all counties.)
24.dress(Number and Street)
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City, State ZIP Code County Primary property owner contact name E-mail