Homestead_Keehn 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)
SPM Development Inc.
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
304 E SR 68
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 '
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 complete as re wired bylaw,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
•eofSgl- . Si.nature of Seller
6 I. 6 edilli iGarli ►11, iitm. goiY a� `Sign Date MM/DD/YYYY)
Print-. '� e of Sel er Sign Bate 1• DD Y ed Name of Seller
.F :UYER(S)/GRA ' E(S)-APPLICATION Fe- PROPERTY TAX D '- ' .` - DENTIF , AT AP b'—
Adam K. Keehn Lauren . Keehn
s'.)
Buyer 1-Name as appears on conveya •e document. Buy 2-Name as appears on conveyance document
515 S. 8th Ave. 51 S. 8th Ave.
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
SE THA PLY.
YE NO CO ITION YE NO CONDITION
❑ . Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of prima 4. Solar Energy Heating/Cooling System
residence, including county: . Wind Power Device
1437 W Chukar Hollow ❑ Hydroelectric Power Device
Address(Number and Street)
— ---r— i Gibsonl. ❑ ��7. Geothermal Energy Heating/Cooling Device
.. — —- -------
;Haubstadt, IN 4 County 0 Is this property a residential rental property?
I: e ZIP Code ❑ 8 Would you like to receive tax statements for this
2. Does the buyer have a homestead in Indiana to l be v property via-email? (Provide contact information
vacated for this residence? If yes, provide complete below. Please see instructions for more information.
address of residence being vacated, including county: Not available in all counties.)
Address(Number and Street) To-I 8^3 30 V^0a[ - 7-s1)^`-04
Primary property owner contact name E-mail
City,State ZIP Code County
License/ID/Other Number