Homestead_Dewig (11) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Criste Wallace Typist
Preparcr()jibe Saks Disclosure Fenn Title
605 S. E. Martin Luther King Jr. Blvd. Southwestern Indiana Land Title
Address(Number and Street)
F-moil
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E,SELLER(S) GRANTORS) ' a _* -a-a z sv a.s ':�, kaJ' _zo :024 +Y-.is 1 Ag.;,r, �.*.me,_: .444. l �r .�, K.
Jason M DeWig -
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance doewnent
P.O- Box 30
Address(Number and Street) Address(Number and Street)
_Haubstadt.IN 47639
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".
'r, 0 4/ .
Signature of-Seller e/� Signature of Seller
.Jason_vl. DeWg tl i F 0
Printed Name of Seller Sign(PAW
Printed Name of.Seller Sign Date(NM/DD/MY)
- I'EEE(S4-APPLICATION`FQR P V.ERTX_7'A%,51EDUC'rrO8__IDENTilE 'A :L,'i7EIvfs iifAT SI5KXr f r`
Peggy D. De +
7-an++:.nsnnnr•ar• conveyance document A. Buyer2-Name as appears on conveyance document
10722 S. Oak Ridge Est. —
Address(Number and Street) Address(Number and Street)
Haubstadt,IN 47639
FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO : • • ■' ' E THAT APPLY. FILED
YES NO CONDITION YES NO CONDITION
El 1.Will this property be the buyer's primary '4 ❑ 3.Homestead Jun 25 2020
residence? Provide complete address of primary U n 4.So ar lie a eating/Cools
residence,including county: ❑ 0 5.Wind Power Device GIBSON COUNTY AUDITOR CB
10722 S Oak Ridge Est
Address(Number and Street) ❑ ❑✓ 6.Hydroelectric Power Device
_Haubstadt, IN 47639 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El 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: glal tions for more information.
Not available in all counties.
Address(Number and Street)
26-23-02-200-001. 990-024
City,State LIP Code County ar • gnat!
nnmyproperty owner con
- Number License/ID/Other Number