Homestead_Barrett (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
;D PREPA.RlR ' V:Y 7 a} *- c
KAREN HARBISON VP
Preparer of the Sales Disclosure Form Title
12894 S SUNSET DR HAUBSTADT STATE BANK
Address(Number and Street) Company
HAUBSTADT IN 47639
E-mail
`'E 8:4 LIF.N'/GRAIR OM)_ .: , . ,;. -, ` ._} :1
WILLIAM J BARRETT I AURA F BARRETT fka LAURA F WI!LIAMS
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
12894 S SUNSET DR 12894 S SUNSET DR
Address(Number and Street) Address(Number and Street)
HAUBSTADT IN 47639 HAUBSTADT 147639
City,State,and ZIP Code City,State,and ZIP Code
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 wi�$ oer
C - .1-5.5,"Real Property Sale Disclosure A t".
tiFSignature ofSellel� Si �'
WILLIAM J BARRETT 01/16/2020 LAURA E BARRETT fka LAURA E WILLIAMS 01/16/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
'.F:-:::7 :7-77 .31.,."APPLIEATION-FORRPROPERTY_TA5(DEDUCPm S IDE-NT.IFYALLITEMSTHATAPP,GY_, s
WILLIAM J BARRETT ) LAURA E BARRETT
Raver 1-Name ay nrmenmailay, yance document Buyer 2-Name as appears on conve •docum-t, •
r S.
- - 12894 S SUNSET:DR 12894 S SUNSET DR
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Address(Number and Street) Address(Number and Street) ._... .1 -
HAUBSTADT IN 47639' HAUBSTADT IN 47639 City,State,and ZIP Code City,State,and ZIP Code JAN 2 4 202u1i
•I/ E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO IDENTIFY A6 THOS H T.:WO
YES NO CONDITION YES NO CONDITION IBSON OUNTY AUDITOR
0 ❑ 1.Will this property be the buyer's primary ( E] ❑ 3.Homestead
residence? Provide complete address of primary _ iti
4.Solal r rgy eating/Cooling System
residence,including county:
12894 S SUNSET DR ❑ ID5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
HAUBSTADT IN 47639 GIBSON ❑ z 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 02.Does the buyer have a homestead in Indiana to be ❑ ❑✓ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ I 9.Would you like to receive tax statements for this
complete address of residence being vacated, proper via e-mail?(Provide contact information
including county: a ow.Please see instructlo re information.
Not available in all counties.)
Address(Number and Street)
• 6--22—\u—a90 001 , 02�1 .
City,State ZIP Code County
Prim roperty owner contact naue - ail