Homestead_Wire INDIANA SALES DISCLOSURE FORM SDF ID: 2020 Page 2
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D. PREPARER
Amy Pollard Escrow Officer
• Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street)
E. SELLER(S)/GRANTOR(S)
Jeffrey L. Hale Laura A. Hale
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
607 E. Locust St. 607 E. Locust St.
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
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Telephone Number E-mail Telephone Number E-mail
Under •enalties of perjury, I hereby certify that this Sales Disclosure,to the bes of my knowledge and belief, is true,correct
. •G com•Mete as -e wired by law, a d is prepared in accordance wi h IC 6-1.1- .5, "Real Property S es Disclosure Act".
s -_-_ 47/./ ,-i . J ''' c. /4 ' a.L
ture of Seller !' Signature of Seller
Jeffrey L. Hale 5/4/2020 Laura A. Hale 5/4/2020
Printed N er Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
. UYER(S)1GRANTEE(S APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
C,,.. .
Diane M.Wire
2020
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0/� E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TF S PROPERTY. IDENTIFY XLQOpY AT A LY.
YES NO CONDITION NO CONDITION 1111/ -1up
0 1. Will this property be the buyer's primary 0 3. Homestead lrOR
residence? Provide complete address of prima 0 oar Energy Heating/Cooling System
residence, including county:
❑ 0 5. Wind Power Device
607 E Locust St. 0 0 6. Hydroelectric Power Device
Address(Number and Street)
Fort Branch, IN 47648 Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
Zits:State ZIP Code County 0 0 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be 0 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, incl ding county: below. Please see instructions for more information.
5.5 d 0 [ ' moil f y Not available in all counties.)
Address(Number and Street) ' �
-Evc thI e t County 10 411750 A-/9/'j�.�•
� 0.46
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City,State ZIP Code Primary property owner contact name E-mail
