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•' INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
(D!,EREPARERi 1:;,.1), .t_. .. .. . ,- • ,. , .- ,.t -< -_ ':`:-L,
CHRISTINA LENFERS CLOSING AGENT
Prepare'of the Sala Disclosure Form Title
501 MAIN ST STE 101 BOSSE TITLE CO
Address(Number and Street) Company
EVANSVILLE IN 47708
E-mail
E.SELLR(Sj`'/.GRANT:OR(Sj:u ? : ' {, - -z. _ .•
ADAM J DILBECK ANNIE M DII BECK
Sege I-Nameas appears on conveyance document Seller 2-Name as appears on conveyance document
1 �� ( � L S sa,
Addraes(Number and Street),,// • f 766,5- Address(Number and Street)
City, to
E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co
_..0,i,,,,,, x ,aeg,,,A
ig tare o plete as re Ired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
/ Sf Seiler I1 Signature of Seller y��
ADAM J DII BECK 004/01013 ANNIE M DILBECK (Jv a 4/0701,-
Printed Name of Seller Sian ate(hat Printed Name of Seller Sian Date(M.M Dfl'YYr)
tF, BUYER(SI4GRAI NTEE(S)_�APPLICATIO�•FOR:.P,ROPERTYSTADDEDUC--TI'ONS� iDENTtFYALL iiiilEI<1S;:TDATpAP,P,liY( ' ' '—:l
AARON R. GERLING JENAH J. MILES
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1212 N BOEKE RD Srvy1—fLi
Address(Number and Street) Address(Number and Street)
EVANSVILLE IN 47711
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES 0 CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary [I.]� ❑ 3.Homestead
residence? Provide complete address of primary ❑ Er 4.Solar Energy Hea Col g S m
residence,including county: ❑ ❑, I '
/ 33 L ` �0S 5.Wind Power Devi /
Ad d (N bernn�iey:_��t)"it rh T Jp 1 t-icoL U p 71 hsm- ❑ r 6.Hydroelectric Power Device(
❑ e' 7.Geothermal Energy HeAWkgC kl,tQD
evice
City,S ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ �� Is this property a resid ntial rental a ape ?
vacated for this residence? If yes,provide ❑ L7 9.Would you like to re •j ; . , 41,-nts fir ?Is
complete address of residence being vacated, property via e-G1 it' oytg eopmpparoRtion
below.Please see instructions for more information.
includ' gco f f
' ) (�f �E t : 1� �(�(/otavailable in all counties) n Lk
Address Nu�um'e and Street) . --sue I L 1 1 /1 o�tQr \V '(�pj ��.fl ()co, . l�^Ciry State ZlPCode CyAv"^s JI-1`\J ( County �(l ` name ..Q �n. '
Primary properry owner ronm[[name (i X . -t
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".(Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being d.)
Or a lastka. AZ
Signature of Buyer] _ ] /.�(( N Signa•-a ofBuyerl/Spouse �//
AARON R GERLING I 66—t3 -I �1O,IFN• I MII FS 0S1�`Volt)/ F.
License/ID/Other Number Number License/ID/Other Number