Homestead_Holzappel INDIANA SALES DISCLOSURE FORM! SDF ID Pane 2
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Chris Sullivan ! : . Closer
Preparer of the Sales Disclosure Form ! : Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
City,State,and ZIP Code Telephone Number E-mail
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Phillip Jared Doerner 1 ! , Karen Marie Doerner
Seller 1-Name as appears on conveyance document 1 Seller 1-Name as appears on conveyance document
7963E 700 S 7963E 700 S
Address(Number and Street) Address(Number and Street)
Oakland City,IN 47660 ! ' Oakland City,IN 47660
state,ana all'cone State,ana ZIP cone
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E-mall
Under enalties o 8 erjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and c 1 e .: .uired by law,and is prepared in accordance wi C 6-1.1-5.5,"Real Proper.. Sales Disclosure Act".
� 1 1 , /
'Signature of Se , V 1 Signat re of Seller
Phillip Jared I oemer I I 17070 Karen Marie Doerner 3i1?�2O7O
Printed Name of Seller Sign Da e(MM/DD/YYYY) Printed Name of Seller Sign ate( M/DD/YYYY)
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Bryan L.Holza el I Alyssa N.Holzappel
1 ears on conveyance document Buyer 2-Name as appears on conveyance document
905NUSHwy41 905NUSHwy41
Address(Number and Street) Address(Number and Street)
Fort Branch,IN 47648 Fort Branch,IN 47648
State,and ZIP Code State,and ZIP Code
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E-mall
Mar 13 2020
THE SALES DISCLOSURE FORM MAY BE USED To:APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDE L OF THOSE THAT APPLY.
YES NO CONDITION NO CONDITION
[Y. ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary 4.Solar Energy Heating/Cooling System
residence,including county:9763E 700 S ❑ RI5.Wind Power Device
Address(Number and Street) ❑ 121 6.Hydroelectric Power Device
Oakland City,IN 47660 Gibson i ❑ Il '),-Geothermal Energy Heating/Cooling Device
City,S teZZP ode ; County Li8.Is this property a residential rental property?
[ 2.Does the buyer have a°homestead in Indiana to be ❑ Q 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provideproperty via_e-mail?(Provide contact information
complete address of residence being vacated, e ow.Please see instruct r more information.
(��� �nclu`di�g�qun q I Not available in all counties.)
Oo nclu ))/���(n� 26-20-14-302-000.412-001
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City,State ZIP Code County Primary property owner contact name E-mall