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Homestead_Zellers
'INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D??EREPAERr. ti t . � .,C:7.7 , ` 'sT�s� '�1,'s� s t4 KAREN HARBISON VP - Preparer of the Sales Disclosure Form Tide 803 E STATE HWY 68 HAUBSTADT STATE BANK Address(Number and Street) Company HAUBSTADT IN 47639 812-768-5800 kharbison(Wesbanc.com City,State,and ZIP Code Telephone Number E-mail iaSELIIERIS)%G RAN ToR(S)I'` -' . . ...ac . ,•sF, CRYSTAI M MOORE Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 811 W 1200 S Address(Number and Street) Address(Number and Street) HAURSTADT 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-S.S,"Real Property Sales Disclosure Act". � Al m 1119-/19 Sign a re of Seller Signature of Seller CRYSTAL M MOORF • 11/02/2018 Printed Name of Seller Sign Date(MH/Do/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY) (F?,BUYER(S1/.GRANTEE(S)EiAIREIGHTIO EFOR!P,IYORERTtYtAKiED.OaiQNS`-?IDENTIEY;AE811TE11SiTHATpr 88-8-y? MARY L ZELLERS Buyer]-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 6765 W 400 S • Address(Number and Street) Address(Number and Street) THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSETHA"9BP11PLY7 2018 YES NO CONDITION YES NO CONDITION Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Ene ,,, residence,including county: rye R 1n� F OR 506 N FIRST ST ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ Q 6.Hydroelectric Power Device OWENSVILLE IN 47665 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ ❑� 8 Is this property a residential rental property? vacated for this residence? If yes,provide ❑ o 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 Sweet) a(0—I 1-0► - twv-Oba999-Oa City,State ZIP Code County Primary property owner contact name E-mail