Homestead_Kramer (6) 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) Company
Evansville, Indiana 47713 (
mail
E. SELLER(S)/GRANTOR(S)
Herbert L. Dix Maureen K. Dix
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
704 E.Walnut St. 704 E.Walnut St.
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
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
land co plete as required by law,and is prepared in accordance wi h I 6-1.1-5.5, "Real Property Sales Disclosure Act".
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Signature of Seller 'Signature of Seller .
Herbert L. Dix 6/23/2020 Maureen K. Dix 6/23/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller ., ..n.�e(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFYALLFMJTT '=1°"Ll�
rian L. Kramer Jessica L. Kramer A�
tiuyer'1-lime as appears on conveyance document Buyer 2-Name as appears on ffy conve} dl t7e820
701 E.Tretter Park Dr. 701 E.Tretter Park Dr. J V�v
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
(
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.xYES NO CONDITION YES 0 CONDITION
El1. Will this property be the buyer's primary 0 3. Ho mestea
residence? Provide complete address of primary ❑ p 4. Solar Energy Heating/Cooling System
residence, including county: ❑ El 5. Wind Power Device
631 E 750 S 0 0 6. Hydroelectric Power Device
Address(Number and Street)
Fort Branch, IN 47648 Gibson ❑ El 7. Geothermal Energy Heating/Cooling Device
xCi y,State ZIP Code County El El 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 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
below. Please see instructions for more information.
address of residen being vacated, including county: Not available in all counties.)
Address(Number acid Street) L �,,ry� / ./e^�D�1ao . o /5 7_G a�
�� lJf l�1 —�t 1 N �� `� �('�171 Primary property owner contact name E-mail
City,State ZIP Code County