Homestead_Hillyer INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER KAIEN HARBISON VP Preparer of the Sales Disclosure Form Title 803 E STATE RD 68 THE HAUBSTADT STATE BANK Address(Number and Street) Company HAUBSTADT IN 47693 E.SELLER(S)/GRANTOR(S) - SARAH A CFNFY.TRUSTFF OF THE SARAH A CFNFY LIVING TRUST dated May 6th 2016 Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 914 TAVFRSHAM AVE Address(Number and Street) Address(Number and Street) FVANSVILLF IN 47725 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 Fequped by law,I d is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". UUNnt,1R,, ignature ofSeller Signature ofSeller FILED SARAH A GFNFY-TRUSTEE 5--['-I-20a0 Printed Name ofSeller Sign Date(MM/DD/YYYY) Printed Name ofSeller w on on ( �Sign Date(MM/DD/YYYY) F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY r1Ll.YI PISLMT APPLY _ f 7,-.7S11ARON R HIL.LYER i ? Buyer I-Name as appears on conveyance document Buyer 2-Name as appears o za nt�'% 157 3 STATE RD 68 APT 206 GIBSON COUNTY AUDITOR Address(Number and Street) Address(Number and Street) HAUBSTADT IN 47639 E-mail Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary 071 ❑ 3.Homestead-1 residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 525 S NINTH AVF ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ IZ 6.Hydroelectric Power Device HAUBSTADT IN 47639 GIBSON ❑ Z 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County E 2.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 ❑ 0 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. Not available in all counties.) Address(Number and Street) ��() 2 [� City,State ZIP Code County � p' .=lr�/c,` p' ��"'`•`�� `�=�� J-__� License/ID/Other Number