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Homestead_Gick
INDIANA SALES DISCLOSURE FORM -SDF ID: 2020 Page 2 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) Company Evansville, Indiana 47713 ( E. SELLER(S)/GRANTOR(S) Carolyn Sue Elpers Revocable Trust of 2006 created U/T/A dated April 20,2006,as amended Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 432 S.West St. Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 , 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 nd complete as require by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". a . Signature of Seller Signature of Seller anted Nq a of ' ba e /YYYY) Printed Name of Seller i gate(MM/DD/YYYY) F. R(S)/GRAN S)-APPLICATION FOR PROPERTY X DEDUCTIONS-IDENTIFY ALL ITEMS THA P LEI r M. Evan J. Gick // Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance docMt nt 'I ' 10412 S 290 W 4�2 Address(Number and Street) Address(Number and Street) �195, 04 Fort Branch, IN 47648 ONE City,State,and ZIP Code City,State,and ZIP Code Dell/ ' / ( E-mail Telephone Number SIT©p E-mail THE SAL S DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN D UCTIONS F OFT THAT APPLY. YES NO CONDITION ES NO CONDITION El 1. Will this property be the buyer's ' ry 0 3. Homestead residence? Provide a address of prima 0 p 4. Solar Energy Heating/Cooling System , ' u Ing county: 432 S West St. 0 RI 5. Wind Power Device Address(Number and Street) 0 I21 6. Hydroelectric Power Device rHaubstadt, IN 47639 I� Gibson ❑ RI 7. Geothermal Energy Heating/Cooling Device City, State IP Code C4,unty 0 RI 8. Is this property a residential rental property? ❑ 2. Does the buyer have a homestead in Indian to be ❑ RI 9. Would you like to receive tax statements for t Is vacated for this residence? If yes, provide c mplete property via-email? (Provide contact inform tion address of residence being vacated, including ounty: below. Please see instructions for more ' ormation. Not available in all counties.) Address(Number and Street) /- U-� -o -2JoD-�� , -C& City,State ZIP Code County Primerty owner contact name E-mail Last 5 digits of Buyer 2 Driver's State Last 5 Digits of Social Security Number