Homestead_Emmert (2) INDIANA'SALES DISCLOSURE FORM SDF ID: Page 2
0..PREPARER l . A . .,i. a 1'_ •, yS° S eY -:rt.-11.: .., ^,i . ,4' _ . ::-.7,.
Ray M.Druley Attorney No.4759-26
Preparer of the Sales Disclosure Form Title
505 N.Church Street,PO Box 146 Law Office of Ray M. Druley
Address(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 drulevlawE)yahoo.com
City,State,and ZIP Code Telephone Number E-mail
E,SELLER(S)/GRANTOR(S)°,"C . t. -1 J'
Steohen F Emmert Personal Representative
Sdler I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
64721 upine Terrace
Address(Number and Street) Address(Number and Street)
Indianapolis IN 46224
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 and i prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
"Signature (Seller Signature of Seller
Stephen F.Fmmert Personal Representative 2/2/2017
Printed Name of Seller Sign Date(MM/DO/YYY) Printed Name of Seller Sign Date(MM/DD/YYI'Y)
GRANTEES) APPLICATION FOR PROPERTY.TAX DEDUCTIONS'-IDENTIFY ALL IT P .
Gregory J. Emmert ��
•^ conveyance document Buye rT-Name as appears on conveyance document
106 S.Vine Street MAR 9 2017
Address(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION .YLS NO CONd1T7HN�
12 El 1.Will this property be the buyer's primary / 12 ❑ 3.Homestead
residence? Provide complete address of primary eating/Cooling System
residence,including county: ❑ 12 S.Wind Power Device
106 S Vine Street
Address(Number and Sweet) ❑ 0 6.Hydroelectric Power Device
Haubstadt,IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El❑ 0 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 ❑ 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)
026 -if - 31 - 303 - coo . 095'-009
City,State ZIP Code County
Primary property owner contact name E-mail