Homestead_Martin (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
I I--t o 'ere-r e. CLOSER
...,•..,e,co use awn,..;c osure Form Title
5231 Oak Grove Rd.,Ste.A TOTAL TITLE SERVICES, LLC
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-468-8485
City,State and VP Cade Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) - -
BFNJAMINA HAI BIG PPEZEIgganstN HALBIG
Seller I�-Natne as appears on conveyance document Seller me as appears on conveyance
Jj`J'"II N1J t
Sit (Number and Street) •.dress(Num, tr- ,•
Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and corn as required by I i p epared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
1 •
I•s l I st it I to • Asia
pSignatur Ilex �( Signature I ler •
e,,. .WA NJ A 1-L-g11. q -13-\-1 Wirt-Pk' nnt.1 •{I a1b;3 q -13 -j1
Printed Name ofSeger Sian Date DODEM/YTYY) Printed Name of Seller Sian Date(MM/Da/ITYY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL'ITEMS THAT APPLY
•MES M. MARTIN SHAWN R. MARTIN
nveyance document Buyer 2-,•-• is appears on conveyance ,
`59 a9 .. Dutb, 1DD A . L A 111 ( .1
Address( tuber and Street) Ad,
F+ 6 m y��
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THATVIIYN1- I
YFs o CONDITION YES o' rnTION GIBBON COUNTY AUDITOR
O
. �❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
a S(n,�TIP,COde County
❑ 0 7.Geothermal Energy Heating/Cooling Device
-2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including coon` below.Please see instructions for more information.
1411 Brno\ P 1- , 1 Not available in all counties.)
Address(Number and Street)
7l -adtl r -\ 71o3.°i A 48- 2S- /oo -o0A . or-Y -0AS
City,State ZIP Code County
Primary property owner Contact name E-mail