Homestead_Neufelder (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2018 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)
John M. Higgins
Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
7093 W 250 S
Address(Number and Street) Address(Number and Street)
Owensville, IN 47648
. ,,City,State,and ZIP Code City, State,and ZIP Code
•
I Under penalties of perjury, I her • •• hat this Sales Disclosure,to the best of my knowledge and belief, is true,correct
and com• e'f'- as e• RT•T• "-•reparecLin.accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
. ,��art;
77-e-Of Seller Signature of Seller
Jo Si,M. Higgins 6/4/2018 6/4/2018
• Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MMJDD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX
LES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR . •:••ERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YE$
NO CONDITION ES NO CONDITION
/)'DIY(C ❑ 1. Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary ❑ 4. Solar Energy Heating/Cooling System
residence,including county:
❑ tgC 5. Wind Power Device
7093 W 250 S ❑ (St 6. Hydroelectric Power Device
Address(Number and Street)
Owensville, IN 47665 I Gibson. ❑ ,L 7. Geothermal Energy Heating/Cooling Device
State ZIP Code County ❑ 8. Is this property a residential rental property?
0 2. Does the buyer have a homestead in Indiana to be ❑ 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.
470 9 700 , \ Not available in all counties.)
Address(Number and Street){�// Wl ly/ K/JC��- //-�I q _ 'b -.Z,s - kO .000 . - 2 I
D),)12)45(7)Code �" `�
Primary property owner contact name E-mail
City,State ZIP Code County
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. eal Property Sales Disclos4re Act". (Note: Spouse
informal' n,Social Se unity and Drivers License/Other numbers are 9�t�e essary if no Homestead Dedyc�ion is being filed.)
tat of Buyer�l!� Signature of Buyer o>� ' —