Homestead_Hidbrader INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D. PREPARER
Teresa S. Holifield 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 (812)425-0055 Teresa @swinland.com
City, State, and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Stephanie Morehead
Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
114 S Eileen
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
an__• •• as require. . . • ,a is pi ared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
Sign./ore of Seller Signature of Seller
Stephanie Morehead 11/16/2017 g 11/16/2017
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS TH f_6jrY
n D
Chase Michael Hidbrader Alexa Kaye Hidbrader
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance doo4hrent
300 N Main St 300 N Main St 2 Q
Address Fort Branch, IN 47648 Fort Fort Branch IN 47648 G/es. e c'4/0
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLVT
YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyers primary 0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System
residence, including county:
❑ 0 5. Wind Power Device
114 S Eileen Ave.
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt, IN 47639 i Gibso ❑ 0 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County ❑ 0 8. Is this property a residential rental property?
0 ❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
300 N. Main Street
Address(Number and Street)
Ft. Branch, IN 47684 GIBBON 24 i S-3(o-'(904 - coo 1 37 00 9
City, State ZIP Code County Primary property owner contact name E-mail