Homestead_Lamey (29) INDIANA SALES DISCLOSURE FORM SDF ID: • Page 2
D.PREPARER
Kathy Masterson CLOSER
Preparerof the Sales Disclosure Form Tide
501 Main Street,Suite 101 Bosse Title Company,LLC
Address(Numberand Street)
E-mail
E.SELLER(S)/GRANTOR(S)
• erry J.Lamey
Sel -Name as appears on conveyance document Seller e-Name as appears on conveyance document
1002 W.
Address(Number and Street) Address(Number and Street)
Haubstadt,IN 47639
City,State and ZIP Code City,State,and ZIP Code
) }L@_sit-co.net
Telephone Number Teephone Number E-mail
Under penalties of perjury, I hereb et ffy iat this Sales Disclosure, a best of my knowledge and belief, is true, correct
and complete as required ,and is prepared in accordance with 1C 6-1.1-5.5," oklerty Sales Disclosure Act".
Signer a ter Signature of Seller
erry J.Laney 12/18/2019 12 8/2019
Printed Name afSeller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Dote(MM/DD/YYFY)
F.BILYER(S)GRANgE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
�NIatthew G.Lamey Katelyn R.Lamey
er 1-Name as appears o *once document Buyer 2-Name as oppe art on conveyance document
1190 72 E. 11904 S.200 E.
Address(Numberand Street) Address(Number and Street)
9 E-mail
...--
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPER I NTUY ALL OF THOSE THA APR Y.
YES NO CONDITION / YES NO CONDITION
'F' ❑ 1.Will this property be the buyer's primary > ❑ .Homestead GI SON COUNTY AUDITOR CB
residence? Provide complete address of primary eating/Gaoling System
residence,including county: y
❑ 1r 5.Wind Power Device
1002 W.1200 S. 0 Er 6.Hydroelectric Power Device
Address(Number and Street) ❑ [1' 7.Geothermal Energy Heating/Cooling Device
Haubstadt,IN 47639 Gibson ❑ Er,8.Is this property a residential rental property?
City,State ZIP Code County ❑ �'
9.Would you like to receive tax statements for this
❑ 2.Does the buyer have a homestead in Indiana to be property via e-mail? (Provide contact information
vacated for this residence? If yes,provide below.Please see instructions for more information.
complete address of residence being vacated, Not available in all counties.)
including county:
11904 S 200 E
Address(Number and 5treer) ].<-2 2-12-300-000. 616-02 4
HAUBSTADT IN 47639 GIBSON
