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Homestead_Palmer (2) INDIANA SALES DISCLOSURE FORM SDF ID:AraG________2__ Da l0000 e 2t Page 2 D,PREPARER • ' Michelle Haynes Closing Agent j Preparer oldie Sales Disclosure Form Title 501 Main Street,Ste 101 Bosse Title Company Address(Number and Street) Company Evansville, IN 47708 E•mall l E.SELLER(S)/GRANTOR(S) Christine M Ingler Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 12693 S 350 F Address(Number and Street) Address(Number and Street) Haubstadt IN 47639 E-mail Telephone Number E-mail Under i• ..Ides of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct a t = o t $ et;as re t ired by law,a ?T t " Iau: d in accordance with IC 6-1.1-5,5,"Real operty Sal Isclosure Act". igna ture of Seller Signature of Seller Christine M ingler 04/01/2011 Printed Name o Seller Slgn Date(MM/DD/YYYY) Printed Name of Seller gn°f h•••,'YY11 j F.BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL ITEMS T 4.L., t t .; Theodore H. Palmer Joni R.Palmer ., _ Buyer I-Name as appears an conveyance document Buyer 2-Name as appears on conveyance ocument JUN 2�20 25633 N County Road 2500 E 25633 N County Road 2500 E (� Address(Number and Street) Address(Number and Street) V� Manito,IL 61546 Manito, IL 61546 • t---`„r E- ail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT A LY. YES NO CONDITION YES NO CONDITION ✓❑ ❑ 1.Will this property be the buyer's primary J❑ ❑ 3.Homestead residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System residence,including county: ❑ ❑✓ 5.Wind Power Device 12693 S.350 E Address(Number and Street) ❑ ✓❑ 6.Hydroelectric Power Device Haubstadt, IN 47639 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ Q 8.Is this property a residential rental property? ❑ 0 2.Does the buyer have a homestead in Indiana to be vacated for this residence? If yes,provide ❑ ✓❑ 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) tr1 2 4. fib'- 3—k5-`10o—soot .777 ..0 City,State ZIP Code County Primary property owner contact name E-mail