Homestead_Harvey INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Elysea M Ledman Settlement&Quality Assurance
Preparer of the Sales Disclosure Form Title
3930 Mezzanine Drive, Suite C Columbia Title, Inc.
Address(Number and Street)
E.SELLER(S)/GRANTOR(S) _
Blake W. Maurer Kelly L. Maurer
Sel r 1-Name as a pears n conveyance docu ent S ller2-Name as ppear on conveys ce docum t
II 010 tA0 tarry .I� I I D 10 -i0 is rSd'c fir.
Add (Number and Str t) ress(Number a d eet) ,1\3( q i A„2„.0
q,770.0
6 rikY1/1 1 te , 1 tt_'_
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 complete as required by law,and is prepared in accordance with C 6- 1-5.5,"Real Property Sales Disclosure Act".
z l/
of Seller 1�"� 2 �j Signa ure of
Blake W. Maurer `v`a3-6 L 'FILE3-
Signature
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Si.n Date(MM/DD/YYYY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS NM El'it.'I 1B
len G. Harvey Amanda S. Harvey
- appeam on conveyance document Buyer 2-Name as appears on conveyance docu t ,
300 East Locust Street 300 East Locust Street
Address(Number and Street) Address(Number and Street) GIBBON COUNTY AUDITOR
Fort Branch, IN 47648 Fort Branch. IN 47648
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
0 ❑ 1.Will this property be the buyer's primary 171 ❑ 3.Homestead
residence? Provide complete address of primary ` ❑ d 4.Solar Energy Heating/Cooling System
residence,including county:
��a, E ��� ❑ ❑✓ 5.Wind Power Device
Vodr`es umberC as—trreet)LoA' ���� l' (_ % ❑ Z 6.Hydroelectric Power Device
c k- �Cx�C�Y� �� `i- �u ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
E z 2.Does the buyer have a homestead in Indiana to be El ❑� 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 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: below.Please see instructions for more information.
. Not available in all counties.)
Address(Number and Street)
A - iq -18 - 2D3 -o00. -3,13 - DAL.(
City,State ZIP Code County
Primary property owner contact name E-mail