Homestead_Mraz • f '„ '
4:,CAGESESDISCLOSUREFORM SDFID:
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tifiZre
Timothy Shea Closing Services
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
-d3- =om r-ra.. a _x"s.'s a '17: , ,,Ye s .ra .Cindy Dewig Esarey now known as Cindy Weber
Seller I-Name as appears on conveyance document
7848 S 10 E Sellerl-Name dsappm co
nveyance
Address(Number and Street) Address(Number and Street)
Fort Branch,IN 47648
sate.ana LW Cale l' // .cart UMW)"wag
(
E-mail
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 complete as++required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
C L v1 , z;'lur--
Signature of5 Signature of Seller
Cindy Dewig Esarey now known as Cindy Weber b7j'tI/a)
Printed Name of Seller Sign Date N D Printed Name of Seller Sign Date(MM/DD/riYt)
IF': ' TEE(SIITAP.PPICATION FOR+PROPERTYnTAX I>EDUCTIONSY:IDENTIFY'ALLSITEMS THAT9APPL•Y-e .a iw.^h."u' 'a::i
Joseph E.Mraz Jessakka M. Schermerhom
s appears on conveyance document Buyer 2-Name as appears on conveyance document
403 E. Strain Street 403 E.Strain Street
Addres(humber and Street) Address(Numberand Street)
Fort Branch,IN 47648 Fort Branch,IN 47648
SE THAT APPLY. May 022019
Y NO CONDmON
ESN YES❑ I.Will this property be the buyer's primary 3. Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of prima ar nergy Heating/Cooling System
residence,including county:
605 E Oak Street El El S.Wind Power Device
Address(Number and Street) 0 El 6. Hydroelectric Power Device
Fort Branch, '47648 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
My,State ZIP e County ,L-y,"/
❑ 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide El H 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 iristructions for more information.
Lai).-
( Q Not available in'rall counties.)n .
Address(Number and Street) ai)�` l"1Ct-1Q' a-00Q5'-O — L
Joseph E.Mraz Jessakka M. Schetmer om V .
Ot State ZIP Code County Primary property owner contact name
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