Homestead_Franklin INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
.D.PREPARER
KAREN HARBISON VP
Preparer of the Sales Disclosure Form Tide
803 E STATE HWY 68 HAUBSTADT STATE BANK
Address(Number and Street) Company
HAUBSTADT IN 47639 812-768-5800 kharbison @esbanc.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) -- - - °':
CHASF H SAVAC;F
Seller I-Name as appears on conveyance document Seller 2-Name as appeon on conveyance document
1933 SOUTHEAST BLVD
Address(Number and Street) Address(Number and Street)
EVANSVII I E IN 47714
' 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".
(//1____ _��� Wu 1/20/7
Signature of Seller Signature of Seller
CHASF H SAVAC;F 11/03/2017
Printed Name of Seller Sian Date(MM/DD/YYYYI Printed Name of Seller Siq a O /D )YY)
F/.•BUYER/S1 R4 JTEEF(S)-,APPLICATION FOR PROPERTY.TAX DEDUCTIONS-:IDENTIFY ALL.ITEMS T
' EVAN H F&ANKLINJ EVAN W FRANKLIN ,/
`'—B y..r His as appears on conveyance document Buyer 2-Name as appears on conveyance document NU y 1 3 207
9739 W 520 S _ 329 S 5TH AVE APT 35
Address(Number and Street) Address(Number and Street) ,
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION ...7 Evan (12. NO CONU • '
0 ❑ 1.Will this property be the buyer's primary rIII` III ❑ 3. Homestead
residence? Provide complete address of primary - ❑ ❑ . . . - -- - - ' g/Cooling System
residence,including county:
LI
505 N SECOND ST 5.Wind Power Device
Address(Number and Street) ❑ VI 6. Hydroelectric Power Device
OWENSVILLE,IN 47665 - GIBSON ❑ 2 7.Geothermal Energy Heating/Cooling Device
Ciry,State ZIP Code County
❑ Q 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 ❑ 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 county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
'/7 - o/ - `log -Boo . 417 Y-04 .2.
Ciry,State ZIP Code County
Primary property owner contact name E-mail