Homestead_Welp INDIANA SALES DISCLOSURE FORM SDF ID: _ Page 2
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Jillian Haase Closer
Preparer of the Sales Disclosure Form Title
606 Main St. Dubois County Title
Address(Number and Street) Company
Jasper;IN 47546 812-482-1696
City,Stare,and ZIP Code Telephone Number E-mail
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rE.SEI:LER(SfARANTiORCEL-_ -_ _:
David Hipp Mary Jo Him)
Seller l-Nam asp pears on conveyance documen J Seller 1-Name as appears on conveyance document
(t )Z 5 5 ,a it e c,Le tr" Same
Address(Number and Street) Address(Number and Street)
14t. Uhs-fcd.4. IA) Lo63I
Telephone Number 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 completQ�s req ed b 'law,and is prepared in accordance with IC 6-1.1-5.5,"Real Pro ay Sales Disclosure Act".
Signature of eller Signature (Seller r
David Hinn 09/10/2018 Mary Jo Hioo 09/10/2018
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYnt
rt:BUYiER(S)'/,GR'i\NTEE(Sfrt2APPL'ICATIO\'iF,QR;RROPERTrY_TAWED"UC-TIQNSdIDENT+IFY_ALL`dTiEMS:T:HAT APRCYb -. _ _ _
WBuyir!- amenein Chelsea NaWeba — _I D
Buyerl�Nomeas appears on conveyance document Buyerl-Nome as appears anc v ar d omen
111 S tv_f2 b_e r (D, Same
Adcrcifumber and Scree. �i Address(Number and Street)
Libs V' I (ti U-263 ti 2r 13O SEP , a 2m8
Telephone Number E-mail
THE SALES DISCLOSURE FORM.MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL06- Tbibll `H�' Y AUDITOR
YES NO CONDITION I YES�/ NO CONDITIONJJ II
(�❑ 1.Will this property be the buyer's primary Lh ❑ 3.Homestead
residence? Provide complete address of primary ❑ V 4.Solar Energy Heating/Cooling System
residence, including county: ❑ S.Wind Power Device
et-e C4 S ct bdv-2—
Address(Number and Street) ❑ a 6. Hydroelectric Power Device
G: 5o n ❑ Ni 7 eothermal Energy Heating/Cooling Device
City.State ZIP ode County L�K/
❑ 2. Does the buyer have a homestead in Indiana to be ❑ $•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.
Not available in all counties.)
Address(Number and Street)
,,6-\8 - 6 - 'AO? -000 . 2q1 -oo9
City,State ZIP Code County
Primary property owner contact name E-mail
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