Homestead_Wright •
..INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
:D PREP.ARER/WWW: 'b � —- _«'d er,z, 7<i rr. ' v :: r. s` .56
KAREN HARBISON VP
Preparer of the Sales Disclosure Form Title
803 E STATE RD 68 THE HAUBSTADT STATE BANK
Address(Number and Street) Company
HAUBSTADT IN 47639 812-768-5800 kharbison(eesbanc.com
City,State,and ZIP Code Telephone Number E-mail
SELfLER[S)/,GRANTOR(S) ,4 ' " iw e e . .: �: u: °. ca_-•. •r-:°=3f,„
ROBERT DAI F MCCI AIN
•- Seller I•Name as appears on conveyance document Seller 2-Name as appears on conveyance document
301 S STH AVE
Address(Number and Street) Address(Number and Street)
HAIIRSTADT IN 47639
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 Prop Di oc t-- - C.
i _ IT r _i
Signature of Seller Signature of Seller
ROBERT DAI F MCCI AIN 06/15/2018
Printed Name of Seller Sign Date(NM/OD/FM) Printed Name of Seller _ d�' , F 'ate(HM/DiY])
¢F?r :YERf3TJ,G 4 t S)` APP.L1GaT10NtF,OR PROP.EItT(YtTAX?DEDUC-TI.ONS-`-a`1DENifIF„} AINL ITEMSjtTllArgAPP,sx�s"�`
•
BRANDON S WRIGHT NATAL! M WRI HT I-. _. nw-Au
- .. :• ..
-- .. -
onveyance document Buyer 2-Name as appears on conve-GIBSON doe_ COUNTY AUDITOR
• 10183 S QUAIL CROSSING 10183 S QUAIL CROSSING
Address(Number and Street) Address(Number and Street)
HAUBSTADT IN 47639 HAUBSTADT IN 47639
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PR l ALL OF THOSE THAT APPLY.
• YES NO CONDITION YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary L q.Sotar energy eating/Cooling System
residence,including county: ❑ ❑
312 N VINE ST 5.Wind Power Device
Address(Number and Street) ❑ Z 6.Hydroelectric Power Device
HAUBSTADT IN 47639 GIBSON ❑ Q 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
❑ 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.
10183 S QUAIL CROSSING Not available in all Counties.)
Address(Number and Street)
HAUBSTADT IN 47639 GIBSON 26-1ek 31 —Z01 —000 .Thr — X01
City,State ZIP Code County
Primary property owner contact name E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
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