Homestead_Martin (8) - J
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)
Raymond V. Martin Phyllis A.Martin
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
7395 W SR 165 7395 W SR 165
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 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 complete as required by law,and is prepared in accordance with IC 6-1.1- 5, "Real Property Sales Disclosure Act".
\Signature oPSel/er ii nature eller
Raymond V.Martin 4/14/2017 Phyllis A.M r in 4/14/2017
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Darin L. Martin Aimee R. Martin
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
2421 W 1025 S 2421 W 1025 S
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 0 THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/CAQling Syste
residence, including county:
7395 W State Road 165 ❑ 0 5. Wind Power Device 19 20U
Address(Number and Street) ❑ 0 6. Hydroelectric Power: ice
Owensville, IN 47665 I Gibson ❑ 9 7. Geothermal€ r .,:-1 e.• -fie Device ,
City,State ZIP Code County ❑ 9 8. Is this property a residB, WOi = .roperty?
0 ❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax state -, c jr 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.
kl ` , ' 102s Not available in all counties.)
Andress( I 2 mber and Street)
I—f� v611ALA I{r LEI i4° ' u-I(930 Z ro I7 /a kt7 co h0 9 0 a
City,State ZIP Code County Primary property owner contact name E-mail