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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
DfPREPARER^ .
Ray M.Druley Attorney No.4759-26
Preparer of the Sales Disclosure Form Tide
505 N.Church Street,PO Box 146 Law Office of Rav M. Druley
Address(Number and Street) Company
Fort Branch. IN 47648 812-753-4975 drulevlawf@yahoo.com
City,State,and ZIP Code Telephone Number E-mail
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E.SELLER(S)/GRANTOR(S). = `� `•
Scott St Clair Sr
Seller I-Name as appears on conveyance document Seller 2-Name as a ears on conveyance eyvnce dacumem
7500 Syls Dr
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and compl
Att�teas require y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signatur ( lb Signature of Seller ��''11a$ �1
Srntt eel St Name of Sr 12/12/2017 to(MM/ f p.� fl A J [i-•1 D�Yn
Printed NameofSel/er Sian Date(MM/Da/YYYYJ Printed Name o Seller u � �I q ,s{�,tpptt��((yy��
F;BUYERS)/GRANTEE(S),AP..PLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT.APPLY '
/Mich lea lea J.DeLong Lori DeLong DEC 2 8 2017
\`Buyer4—N on conveyance document - — ' Buyer 2-Name as appears on conveyance document
415 S.Mill Street 415 S.Mill Street
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—YES NO—CONDIE QN /1
NI ❑ 1.Will this property be the buyer's primary ( Fl • 3.Homestea• / D/ r,4 j3C,
I
residence? Provide complete address of primary ❑ is 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0 5.Wind Power Device
415 S Mill Street
Address(Number and Street) ❑ Fl 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 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 ❑ Fl 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)
°Z
City,State ZIP Code CauCounty Co " /7 - / a - Ao y- 000 . 2435-oa 1
Primary property owner contact name E-mail