Homestead_Alston (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
.D.PREPARER
Karen Harbison VP
Preparer of the Sales Disclosure Form Title
803 E State Hwy 68 Haubstadt State Bak
Address(Number and Street) Company
Haubstadt IN 47639
E-mail
E.SELLER(S)/GRANTOR(S) - 1
Jo Ann Rosenberger Jack D. Rosenberger,Attorney-in-Fact for Jo Ann Rosenberger
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
106 Shawnee Dr
Address(Number and Street) Address(Number and Street)
Natrona Heights, PA 15065
City,State,and ZIP Code City,State,and ZIP Code
Telephone Number 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 required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
G-,9-Z41,a(( -epa- PDX
Signature of Seller Sig ture of Seller ,
Jack D Rosenberger.Attorney-in-Fact 06/10/2020/
Printed Name ofSeller Sign Date(MM/DD/YYYY) Printed Name ofSeller Sign Date(MM/DD/YYYY)
S GRA -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT A j. j
- Lance C Alston Lauren L AI ton �� 'r,�
Buyer 1-Nome as son conveyance document Buyer 2-Nam pears on conveyance document >
11880 S Honeysuckle Lane 11880 S Honeysuckle Lane ✓e/
21
Address(Number and Street) Address(Number and Street) 1/ I, . J {
Haubstadt IN 47639 Hau d IN 47639 G (.R
City,State,and ZIP Code City,State,and ZIP Code O .
j _ E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. 1(/(/
YES NO CONDITION O CONDITION /r�
AN
❑ 1.Will this property be the buyer's primary - ( Z 0 3.Homestead
residence? Provide complete address of prima nergy Heating/Cooling System
residence,including county:
201 S Race St ❑ ❑✓ 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ IZI 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 ❑ 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.
11880 S Honeysuckle Lane Not available in all counties.)
Address(Number and Street)
Haubstadt IN 47639 Gibson d�i95/-,f0Z_ COO. �9
City,State ZIP Code County
Primary property owner contact name E-mail