Homestead_Martin (28) INDIANA SALES DISCLOSURE FORM SDF ID: Paget
.D BREPARER ."s. t - r . . , '` . . ..- .
Jennifer Wade Closer
Preparer of the Sales Disclosure Form Title
7820 Eaele Crest Blvd Ste 201 Reeional Title Services
Address(:Number and Street) Company
Evansville, IN 47715 (812)759-5555 closines@alreeionaltitlellcom
City,State,and ZIP Code Telephone Number E-mail
\lark A. Brown Daisy T. Brown
Seller 1-Name as appears on conveyance document Seller I-Name as appears on conveyance document
901 E Walnut 901 E Walnut
Address(Number and Street) Address(Number and Street)
Ft Branch, IN 47648 Ft Branch, IN 47648
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 complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
GPt
Signature of Seller (/ Signet re of Seller
Mark A. Brown 0/1 Z-7 2 o(d Daisy T. Brown, By Mark A Brown, as her Attorney in Fact Ge//77/7 4S
Printed Name of Seller Sign Dt a(MMI D/ITYt) Printed Name of Seller Sign Date(MM/D0ft 0 f
:FiBUYERfSl/GRANTEE(Sj'.-iAPPLICATION FORPROP.F.RTYnTAX1DEDUCTIONS`TfiENTIFY;ALI ITE A .AP. T
arles T Martin Brittany S. Martin
Buye , o)uppeun on conveyance document Buyer 2 Name as appears an conveyance document
510E Elm St 510E Elm St nr �j8
Address(Number and Street) Tess umber and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
mail
THE SALES DISCLOSURE FORM MAY BE 115E1)TO APPLY FOR CERTAIN DEDUCTIONS FOR TIIIS PROPERTY. IDENTIFY ALI.OF THOSE TIIAT APPI.V.
YES NO CONDITION YES CON ION ..
( El 1.Will this property he the buyer's primary ❑ 3. Ilomes[ea
residence? Provide complete address of primary M 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
901 E Walnut Street I S.Wind Power Device
Address(Number and Street) 0 0 6. Hydroelectric Power Device
Fort Bran , IN 47648 Gibson 0 0 ..Geothermal Energy Heating/Cooling Device
City,State cage County ❑ ,Ei (8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be 0 0 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide property via e-mail?(Provide contact information
complete address of residence being vacated, below. Please see instructions for more information.
including county: Not available in all counties.
Address(Number and Street) ,-47 -/7 -/E -30T -0 00. On -0 ate
Charles"1'. Marto Brittany S. Martin
City,State ZIP Code County Primary property owner contact name E-mail