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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Rexanne McCauley Title& Escrow Processing .
Preparer of the Sales Disclosure Form Title
3930 Mezzanine Drive, Suite C Columbia Title,Inc.
Address(Number and Street) Company
Lafayette, IN 47905
E.SELLER(S)/GRANTOR(S) —
George A Dunkel and Juanita A Dunkel Living Trust dtd 6-13-2018
Seller 1-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
'i . F \-\\csc4, L ry:As Lrl
Address(Number and S.. t) Address(Number and Street)
\-\e•-v�s A ) t N L\-1 (D3°\
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 comp) a as required ylat , nd is prepay din accordance with IC 6-1,1-5.5,"Real Property Sales Disclosure Act".
a- - I
4-
tgnature of Seller Signature of Seller
!manna A Dunkel S TTF by David A Dinkel AIF 6/21/2019
Printed Name of Seller Sian Date()4M/DD/YYYY) Printed Name a Seller 1 Sia te(MM/DD
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL 1A P JL
reith Howard
-avye. . Naarra appears on conveyance document Buyer 2-Name as appears an conveyance dam, 1 0 (t
501 East Ulen Street firer
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648
City;State,and ZIP Code City:State,and ZIP Code
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES N
z ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of primary M k6 4.Solar hnergrueating/Cooling System
residence,including county: ❑ ❑
501 East Ulen Street S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State�Z/IPya�da County
❑ LK 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 ❑ WI 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 Street)
C 6 _ /9-(8 - 30i - 000. leo •o04
City,State ZIP Code County
Primary property owner contact name E-mail
Number License/ID/Other Number