Homestead_Echert (2) 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 (
E. SELLER(S)/GRANTOR(S)
Antoinette F. Kissel
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
167 E 1200 S
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
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 6-1.1-5.5, "Real Property Sales Disclosure Act".
Signature of Sellers_ 1��'� Signature of Seller
Antoinette F. Kissel ( ')l Lk7,,)01 7
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
Linda Echert Ryan Echert PIT
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance documehl- A./..../tit
304 N Vine St 304 N Vine St
Address(Number and Street) Address(Number and Street) RI( 3 0 2017
Haubstadt, IN 47639 Haubstadt, IN 47639 -
TOR
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
i ❑ 1. Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary ❑ .tT T 4. Solar Energy Heating/Cooling System
' residence,including county:
167 E 1200 S ❑ -9 5. Wind Power Device
Address(Number and Street) ❑ 6. Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ Q 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County ❑ 7 8. Is this property a residential rental property?
(-1) ❑ 2. Does the buyer have a homestead in Indiana to be ❑ Cp 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
_ad+dress of residence being vacated, including county: below. Please see instructions for more information.
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( „,� 5-t— \ Not available in all counties.)
Address(Number and S reet) r
tiokt- cTA-or or{ i- )(Q9 (t,11a5U a-a,3-I d- - • $U-O 4
City,State ZIP Code County Primary property owner contact name E-mail