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Homestead_Fuesting INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER _ _ Britany Barnes Agent Preparer of the Sales Disclosure Form Title 226 W Broadway Broadway Title, Inc Address(Number and Street) Company Princeton,IN 47670 812-386-1687 britany.bti @mw.twcbc.com City,State,and ZIP Code Telephone Number E-mail E:SELLERS)/GRANTOR(S) . . Bradley J. Simms Beth A. House-Simms Seller I'Name as appears on conveyance document Seller I.Name as appears on conveyance document 10360 S Pheasant Run -103605•PheasantRun Address(Number and Street) Address(Number and Street) Haubstadt,IN 47639 Haubstadt, IN 47639 Under p' alties of perjury,I he ty certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and c y plete as required by,�,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". �..,itt��� 1 !`- 2 1Rf4$-- LEI-'neil " juncture of Seller or Signature of Seller Bradley J.Simms Beth A. House-Simms Printed Name of Seller Sian Date(MM/DDMTT) Printed Name of Seller Sian Date(MM/UDMYY) F;BUYER(S)/GRANTEE(S)'-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY , Dale I Fuesting Paula S. Fuesting meaap r LED Buyer)"Nameos appears on conveyance document Buyer?"Name as appears on conveyance dot t 4033 Ridgetop Ct 4033 Ridgetop Ct Address(Number and Street) Address(Number and Street) Newburgh, IN 47630 Newburgh, IN 47630 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE Sa '-COUNTY AUDITOR YES NO CONDITION I YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary 12 ❑ 3.Homestead residence? Provide complete address of primary ❑ 2 4.Solar Energy Heating/Cooling System residence,including county: 10360 S Phasant Run ❑ rj 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Haubstadt, IN 47639 ❑ 12 7.Geothermal Energy Heating/Cooling Device ry.State ZIP Cade County Li 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 ❑ 12 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information below.Please see instructions for more information. " d ding c unty: � f f r�rtt�n — Not available in all counties.) A'd-ress-- 'umber it Street) SI 9 r a( -1 - 36- 300 - °DIOR -pay• City,State ZIP Ca 9 County Primary property owner contort name E-mail