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Homestead_Reising INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER• ,.-&'‘3.- .' rL3 ... . ?GF. : ,>.-,er24P 1 a .'G? sy > ..i 1" ''' r` ^' . k - t^ -r `. . :.r.1.- KAREN HARBISON VP Preparer of the Sales Disclosure Form Tide 803 E STATE HWY 68 HAUBSTADT STATE BANK Address(Number andSaees) Company HAUBSTADT IN 47639 812-768-5800 kharbisoneesbanc.com City,State,and ZIP Code Telephone Number E-mail E:SELLER(S)/GRANTOR(S), s. `... «, _._ :• r x . . .$,d. 4 fir'" -_ . WIWAM J GOFDDF I AURA R GOFDDE Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1745 E 1025 S 1745 E 1025 S Address(Number and Street) Address(Number and Street) Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complet requir i$by 1 and is prepared in accordance with IC 6-1.1-5.5,"Real Prope Sales Disclosure Act". "'Signature of Seller , S' nature leer WU I IAM J GOFDDE 05/04/2018 LAURA R GOEDDE 05/04/2018 Printed Name of Seller Sign Date(MM/DD/rvn) Printed Name ofSe(ler Sign Date(MM/DD/YYYY) F.BUYER(S)/GRANTEE(S) APPLICATION FOR PROPERMTAX'DEDUGTIONSciIDENTIF,XALI, " t •T: Y/= it' :'_:'rC «' r ( _.1USTIN N REISIN KAY • : : ING �F Buyer I•Name as appears an conveyance document Buyer 2-Name as appears on conveyance 'Ilw 'Sr' 11437 5160 E 11437 3 150E �AY 9 2u18 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 0 ❑ 1.Will this property be the buyer's primary C 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System residence,including county: ❑ 1745 EAST 1025 S 5.Wind Power Device Address(Number and Saeet) ❑ 0 6.Hydroelectric Power Device HAUBSTADT IN 47639 GIBSON 0 ❑ 7.Geothermal Energy Heating/Cooling Device Ciry•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 ❑ 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. 11437 S 150 E Not available in all counties.) Address(Number and Street) HAUBSTADT IN 47639 GIBSON oli - /9- 3,1 - Yoo _bO I. 017 -oAV City,State ZIP Code County Primary property owner contact name E-mail