Homestead_Lantaff INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
KATHY RENEE MASTERSON CLOSING AGENT
Preparer of the Saks Dhdmvrr Fan, nil
501 MAIN STREET BOSSE TITLE COMPANY
Address(Namberand fleet) Company
EVASVILLE IN 47708
E•mall
E.SELLER(S)/GRANTOR(S)
Cab:rlee Kelly MRsnn
Sent •Name as appears an caaveycan docament Seoer2•Name as appears on conveyance doormat
I•
Address(Number a'• • I) Address(Number and Street)
Oakland City IN 47660
ary,Statm and ZIP Cade Cio'Stataa • ••1e
Telephone Number Telephone Number E-mail
Under penalties of perjury,I hereby certify th- • Sales!)s • - e,to the best of my knowledge and belief,Ls true,correct
and complete as required by law,and• • epared in accordance with • -S.S,"Real Property Sales Disclosure Act'.
Signature af Seller Sigaamre oneeer
r.harlesl{ ASCII 05/01)2019
PG,et'7)ome ofSeler Sian Date(NN/➢➢/mT Printed Name of Seiler Sign Dare(1411/onarr1)
F.BUY R(S}/SRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Denver C.Lanlaf)
Buy -sl - - s on conveyance document Buyer 2-Name as appears an conveyance document
7448 S 950 E
Address(Namber cad Street) Address(Number and Street)
OAKLAND CITY IN 47660
City( amSiena and ZIP Code FILED
ec
Telephone Number Eme Telephone Number May 03 2019 &mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PR .IDFMiFY ALL 45E THAT AP/ItY. ,
YES NO CONDITON YES NO cONDmON J/•�fN..t.'w7f+'�"9"e[`
o ❑ 1.Will this property be the buyer's primary ( ❑ 3.Homest GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary U (2 4.Solar Energy Heating/Cooling System
residence,including county: 0 m S.Wind Power Device
176 N Second Ave
Address(Number cad Street) ❑ 2 6.Hydroelectric Power Device
Oakland C' N 47660 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device
City.State Z1 a County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ El 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ IZI 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: crow.Please see s or more information.
7448 S 950 E Not available in all counties.)
Address(Number and Scree)
OAKLAND CITY IN 47660 GIBSO 26-13-13-402-000. 198.007
City,State VP Code C aty
Pmaary prop corner 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
Number License/ID/Other Number
. INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
KATHY RENEE MASTERSON CLOSING AGENT
Reparerof the Sala Budaare Form Title
501 MAIN STREET BOSSE TITLE COMPANY
Address(Number and Street) Company
EVASVILLE IN 47708
E-mail
E.SELLER(S)/GRANTOR(S)
Chadas Kelly Mason Tip I LED
Seller I-Name an appears on conveyance document Seller 2•Name anappears an conveyanredaovmen
128 N Second Ave Plaay.,"7•�M+'v
03 20119
Address(NuSant)berated Sat) Address(Number and Street)
Oakland City IN 47660 NM
E-mail Telephone Number E-moil
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and corn let r quired aw,and is prepared In accordance with IC 6-1.1-S.S,"Real Property Sales Disclosure Act".
SIBRONRa1SfRK •_ Agawam al Seller
Qhadas Kelly Mason OA/01001g
Printed Name of Seller Sow Date(MM/0D/YM1 Printed Name of Seller Sega Date(MM/DD/YYITI
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Denver C Lantaff
Buyer I-Nameas appears an rmveyw,R document Bayer -Name as appears on conveyance document
7 .: S950E
Add - (Number and Street) Address(Number and Sams)
OAKLA F CITY IN 47660
City,Statc an• PCode Say,State and LP Code
Telephone Number E-mail Telephone Number E-mail
THE SALES DISCLOSURE FO., Y BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDmON YES NO CONDMON
m 0 1.Will this prope . be the buyer's primary 2 ❑ 3.Homestead
residence? Provi r• omplete address of primary ❑ ❑ 4.Solar En •4 Heating/Cooling System
residence,includingc• nty: ❑
Qj 5.WI, • 'ewer Device
12H N Semite!Ave
Addreu(Number andStmet) ❑ 0 . 'ydroelectric Power Device
Oakland city.IN 47660 GIBSON_ ❑ 5 7.Geothermal Energy Heating/Cooling Device
ary.State DP Cade Scanty
❑ ID 2.Does the buyer have a homestead in a Tana to be Era m B.Is this property a residential rental property?
vacated for this residence? If yes,provi e ❑ 0 9•Would you like to receive tax statements for this
complete address of residence being vacate e. property via a-mail7(Provide contact information
including county: below.Please see instructions for more information.
7448 S 950 E Not available in all counties)
Address(Member and Street)
OAKLAND CITY IN 47660 GIBSON
Ory,State DP Code Cowry
Pmonryp ..true owner contact name E+nall
Under penalties of perjury,l h- by certify that this Sales Disclosure,to th- e est of my knowledge and belief,is true,correct
and complete as required ,- aw,and is prepared in accordance with IC 6-1. -.5,"Real Property Sales Disclosure Act".(Note:
Spouse Information,So• , Security and Driver's License/Other numbers are no ,ecessary if no Homestead Deduction is
being filed.)
ggaatonof: . 1 — Signatum ofevyer2/Spm,se - - -
.-,
• ed legal Name of Buyer I Slgn Date 0Mll/DD/fll1 Printed legal NameafBuyer 2/Spouse Sign Date(MNyall ll
Last 5 digits of Ruyer 1 Driver's State Last 5 Digits of Social Securlly Number Lax S digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security
License/ID/Other Number Number License/ID/Other Number