Homestead_Schmitt (23) INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D. PREPARER
Teresa S. Holifield 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 teresa @swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Chad D.Will
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10147 S Hunters Crossing Dr
Address(Number and Street) Address(Number and Street)
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 :s equired by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
�(\ Signature of S-.,er Signature of Seller
Chad D.Will 3/1/2017 gyp 17
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller JI R 9g I:te` s,D/YYYY), .
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
an J. Schmitt Jamie M. Schmitt MAR 7 2017
Cuyca 1 -Namf,a appears on conveyance document Buyer 2-Name as appears on conveyance document
729 S. Norman Ave. 729 S. Norman Ave.
Address(Number and Street) Address(Number and Street) GIBBON COUNTY AUDITOR
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyers primary ❑ 3. Homestea
residence? Provide complete address of primary ❑ eating/Cooling System
residence, including county:
❑ di 5. Wind Power Device
10147 S Hunters Crossing ,y
Address(Number and Street) ❑ 4Y 6. Hydroelectric Power Device
'Haubstadt, IN 47639 I Gibson ❑ m 7. Geothermal Energy Heating/Cooling Device
Ciry,State ZIP Code County ❑ V. 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ JXL 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
194 5- 'IOr�,J �� � Not available in all counties.)
Address(Number and Street)
a,NSYI I I o U7)I q V andfxbl , (26 -I g
owner - 300 - o01. 26a -o E ai
City, State ZIP Code ty Primary property one contact name E-mail