Homestead_Angermeier INDIANA SALES DISCLOSURE FORM SDF ID: 2019 Page 2
D. PREPARER
Kristina Watson Escrow Officer
Preparer of the Sales Disclosure Form 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)
a.
Heather A.Willis _
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyan my
715 Kennedy Dr
Address(Number and Street) Address(Number and Stre
Fort Branch,IN 47648 �`LO\eS /
City,
" ] P
-Telephone Number \ E-mail Telephone Number l a�`' E-mail
Under penalties of perjury I hereby certify that this Sales Disclosure, to the best of my knowledge and be catrue,correct
and/qomplete as required by law, and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sale losure Act".
( ag ture of Seger Signature of Seller
Heather A.Willis— n/fi-ab-,)n i
Printed Name of Seller Sign Date(MMIDD/YYYY) Printed Name of Seller Sign Date(MM/DDNYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Alex R.Angermeier Kassie L.Angermeier
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
214 N Race St 214 N Race St
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
-
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YEy NO CONDITION _ YES NO CONDITION
S,-F,'( ❑ 1. Will this property be the buyers primary E 0 3. Homestead
residence? Provide complete address of primary ❑ p 4. Solar Energy Heating/Cooling System
residence, including county:
0 0 5. Wind Power Device
715 Kennedy Dr.
Address(Number and Street) 0 0 6. Hydroelectric Power Device
Fort Branch, IN 47648 1 Gibsor 0 0 7. Geothermal Energy Heating/Cooling Device
Cjy,State ZIP Code County 0 0 8. Is this property a residential rental property?
cSfu/ ❑ 2. Does the buyer have a homestead in Indiana to be ❑ ❑ 9 Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
add ss of residence being vacated,including county: below. Please see instructions for more information.
rl IL( &I VG, ,u S I Not available in all counties.)
Address(N mbar and Street) 'C
irtt -ts-ia+ , y/ci7G, aAQ-kg-ice- 101 - oo(. 111 - 041JP1
City State ZIP Code County Primary property owner contact name E-mail
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