Homestead_Alexander (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2019 Page 2
D. PREPARER
Amy Pollard Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street)
E. SELLER(S)I GRANTOR(S)
Alex Reed Angermeier Kassie Lynn Angermeier
Seller 1-Name as appears on conveyance document Seller 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
.
L /fi-
Signature of Seller Signature of Seller
Alex Reed Angermeier 9/17/2019 Kassie Lynn Angermeier 9/17/2019
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller _ ._Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AL I . MS F i4TAP;LY
i Tiffney_R..Alexander-) 'I,--
Buyer 1-Name as appears on conveyance document Buyer 2-Name as app on conveyance do Ryiqent
208 N Race St cy S ® .
Address(Number and Street) Address(Number and Street) v
,-------
Haubstadt, IN 47639
THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YE NO CONDITION
❑ 1. Will this property be the buyer's primary 0 3. Homestead
residence? Provide complete address of primary El lI 4. Solar Energy Heating/Cooling System
residence, including county:
214 N Race St. ❑ El 5. Wind Power Device
Address(Number and Street) ❑ lI 6. Hydroelectric Power Device
Haubstadt, IN 47639 1 Gibson, ❑ 2 7. Geothermal Energy Heating/Cooling Device
City,St to lP Code County El El 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ El 9. 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)
1-- 6=LF---3%=301 - QoD—O72/ "a 9^7
City,State ZIP Code County Primary property owner contact name E-mail
License/ID/Other Number