Homestead_Martin (8) •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
_
DIPREPARER
Ray M. Drulev Attorney No.4759-26
Prepares of the Sales Disclosure Form
(Tide
505 N.Church Street,PO Box 146 Law Office of Ray M.Druley
Address(Number and Street) j Company
812-753-4975 drulevlaw(ahvahoo.com
Fort
Branch,IN I Telephone Number E-mail
City,State.and,ZIP de
I
E.SELLERS)/GRANTOR(S):' . - .. -, _
Ronald.1 Grimes
Dorothy N Grimes 1 Seller 2-Name as appears on conveyance document
Seller?-Name as appears an conveyance document I
521 South Ninth Avenue 521 Soidh Ninth Avenue
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a complete as requir d y law,and is prepared in accordance with IC 1.1-5.5,"Real Pro a es Disclosure Act".
�' Signature of Seller ,(�/JY/J.`,(J�/�G�.r
Signature of Seller 8/7017
—1,r, C ITION
Y NO CONDITION '
jl 111 1.Will this property be the buyer's primary 19 0 3.Homestead
residence? Provide complete address of primary , o ar nergy Heating/Cooling System
residence,including county: 0 fil 5,Wind Power Device
521 South Ninth Avenue 0 6.Hydroelectric Power Device
Address Haubstadt, IN 47639 ❑ O
Haubstadi, IN 47639 Gibson 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County 1 0 O 8.Is this property a residential rental property?
0 0 2.Does the buyer have residence?homestead in Indiana to be ❑ 9 Vyould you like to receive tax statements for this
comple ear dresosie Icybe,ngvaca property via e-mail?(Provide contact information
complete address of residence being vacated, below.Please see instructions for more information.
including county: Not available in all counties.)
7345 W SR 168
Address(Number and Street) � / 23 b ! - 0'tQ0 -boo. 8gS'1709
Owensville, IN 47665 Gibson (O t% lA I
Gry,State ZIP code County j E-mail
Primary property owner contact name
License/ID/Other Number