Homestead_Clore (3) INDIANA SALES DISCLOSURE FORM SDF ID: 2019 Page 2
D. PREPARER
Kristina Watson Escrow Officer
Preparer of the Sales Disclosure Fonn Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (
E. SELLER(S)/GRANTOR(S)
Jerrad J.Weber Kasci M. Weber
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
401 E. Strain St. 401 E. Strain St.
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
City,State,and ZIP Code City, State, and ZIP Code
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 c.
omplete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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Sig tore of Seller- L /z�l r Signature;ol;Seller�
Jerrad J.Weber 6(Zi -*— v Kasci M. Weber 1p15 1q
Printed Name of Seller Sign•Date(MM/DDNYYY) Printed Name of Seller Sign'Date(MM/DD/YYYY)
F. BUYER(S)IGRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY ""`, p
Jack V. Clore _ Penny L. Clore
Buyer 1 -Name as appears on conveyance document Buyer 2-Name as appears on at do me
2824 Joe Pruitt Rd. 2824 Joe Pruitt Rd.
Address(Number and Street) Address(Number and Street) Q �019
Navarre, FL 32566 Navarre, FL 32566 ,�N D
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL O Kp 1HAT APPLY.
' YES NO CONDITION CitYES . NO CONDITION GO
l� 0 1. Will this property be the buyer's primary 0 3. Homestead
residence? Provide complete address of primary ❑ ��4. Solar Energy Heating/Cooling System
residence, including county:
0 8-4 5. Wind Power Device
401E Strain St.
Address(Number and Street) ❑ ' 6. Hydroelectric Power Device
Fort Branch, IN 47648 I. Gibson ❑ " .7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County ❑ 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ . Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
0)LO— I CII -19 — I0I- COO 3: 1-Ca
City, State ZIP Code County Primary property owner contact name E-m it