Homestead_Schmits Jr INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
DFPREPARER• ,. r,: - : ) a A T i sic ---
A
Mn Leek Escrow Officer
Preparer of the Sales Disclosure Form Title
7321 Eagle Crest Blvd, Ste A. Foreman Watson Land Title, LLC
Address(Number and Street) Company
Evansville, IN 47715
E-mail
Elf SEILLERnlGRITO -gMf .rip_ '5_ ;:-17v3•s ;t fct�c,�x ^ii iP l, sL SI�ti qi 1£ 41443 A.v }a l
Thomas K. Schmits
c 1-Arms appe n cony:�yr.�ed ent/. Seller 2-Name as appears on conveyance document
•'-LAjAddddJl §b(velryfijStreet)_ �//// QJ / �) Address(Number and Street)
)f`J Jv I{�L/tr^AYI •�c.l[///'^ �lP �tYl/
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 corn lete as re uire
d is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
SighSigh ui Signature of Seller
Thomas K. Schmits 07/19/2019
Printed Name of Seller Sign Date(MM/DD/IYYY) Printed Name of Seller Sign Date(MM/DD/YnT)
:I UYER(S)%G S:'FEB S APPI:ICATIONt'EORPROPERcITTAkDEDUCTIONS_ DENTIFX.:AL S"HA ic` - 1:-;_--7-Tli
( Timothy L. Schmits Jr.
—Thuyer I-No conveyance document Buyer 2-Name as appears on conveyance document
5031 East 575 South JUL 2
Address(Number and Street) Address(Number and Street) 4 2019
Fort Branch, IN 47648 '7
GIHSnnI
Telephone Number E-mail Telephone Number COUNTY AUDh OR E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROP EYTtFY-A F THOSE THAT APPLY.
YES NO CONDITION I ES NO CONDITION
❑✓ 0 1.Will this property be the buyer's primary ❑✓ ❑ 3.Homestead
residence? Provide complete address of primary K ❑ ❑✓ So . eating/Cooling System
residence,including county: ❑ 05.Wind Power Device
5031 East 575 ouch
Address(Number and Street) ❑ ❑✓ 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ D 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
be ❑ ❑✓ 8. Is this property a residential rental property?
❑ NO
Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 0 0 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: a aw. Please see ins do more information.
t� Not available in all counties.)tip
Address(,Numberand Street) T t eV2.—ZoD— 001 ,Q$O 'oZs-
Tt othy L.Schmits,Jr. schmits_t@yahoo.co
City,State ZIP Code County
Primary property owner contact name E-mail
Number License/ID/Other Number