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Homestead_Steelman `INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2 D. PREPARER `+ .Kathy Masterson Escrow Officer it 7 • Prepare,-of the Sales Disclosure Form Title ^; .a•605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title y '. Address(Number and Street) Company Evansville, Indiana 47713 (812)425-0055 kathy@swinland.com 'f. .- City,State,and ZIP Code Telephone Number E-mail 1. 3 E. SELLER(S)/GRANTOR(S) _ — t d !Mary E. Steelman :4 " Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1271 E Steelman Rd - Address(Number and Street) Address(Number and Street) 5. :Patoka, k`., Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct r hd complete as�•uir�d by law, -rid isprepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disc�yurg A Ali]_„_, -... A`__ �� GIBSON COUNTY AIInlTnR Signature•f Seller ' Signature of Seller Mary E. S eelman 4/21/2017 4/21/2017 1. . Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) it F. BUYER(S)IGRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY .Ryan L. Steelman Brandi D.White e' Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document •l -7710 N Shiloh Church Rd 7710 N Shiloh Church Rd . '- Address(Number and Street) - Address(Number and Street) .Hazelton, IN 47640 Hazelton, IN 47640 it.; . a 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 IS .‘g1.1 ❑ 1. Will this property be the buyer's primary ❑ 3. Homestead �` residence? Provide complete address of primary ❑ p 4. Solar Energy Heating/Cooling System V511 .°' residence,including county: ❑ 0 5. Wind Power Device - 1271 E Steelman Rd.3 ❑ El 6. Hydroelectric Power Device - Address(Number and Street) - y ;.:.i. ':^ Patoka, IN 47666 I Gibson ❑ El 7. Geothermal Energy Heating/Cooling Device • fl. 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 • : address of residence being vacated, including county: below. Please see instructions for more information. _v. Not available in all counties.) Address(Number and Street) b-05 Sg- 035-©W aqq-Di 8 'c City, State ZIP Code County Primary property owner contact name E-mail :7s 5B. ,,