Homestead_Beloat (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER ,
Kris Watson closing agent
Preparer of the Saks Disclosure Form Title
501 Main Street,Suite 101 Bosse Title Company,LLC
Address(Numberand Street) Company
Evansville,IN 47708 (
E-mail
E.SELLER(S)/GRANTOR(S)
David E.Utley
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
11192 S.Owensville Rd.
Address(Number and Street) Address(Number and Street)
Haubstadt,IN 47639
City,State,and ZIP Code
E-mail
Under penalties of,? • jury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct
�and complete as r:4j a I. ,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
411PF
/
Signature ofSeller 0 ' Signature ofSeller
David E.Utley 08/17/2020 08/17/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Natnc ofSeller Sign Date(MM/DD/YYYY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Nathan Michael Beloat Rachel Renea Beloat
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
2605 W.1025 S. 2605 W.1025 S.
Address(Number and Street) Address(Number and Street)
Fort Branch,IN 47648
OF THOSE THAT APPLY. ,J Y_-
YES NO CONDITION YES NO CONDITION �f
4 0 1.Will this property be the buyer's primary ilel ❑ 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary
residence,including county: El cEr 4.Solar Energy Heating/Cooling System
❑ OCK 5.Wind Power Device
11192 S.Owensville Rd. ❑ 6.Hydroelectric Power Device
Address(Number and Street)
❑ 7.Geothermal Energy Heating/Cooling Device
Haubstadt,IN 47639 Gibson El 8.Is this property a residential rental property?
City,State ZIP Code County
El 9.Would you like to receive tax statements for this
cjk( ❑ 2.Does the buyer have a homestead in Indiana to be property via e-mail? (Provide contact information
vacated for this residence? If yes,provide below.Please see instructions for more information.
complete address of residence being vacated, Not available in all counties.)
including county:
ac0Z)S U.) - 1Cr?S .3-
Address(Number nd Street)
V -. - bee... ,6 T y',Lt% Q itf - 26-22-10-100-000.087-024
City,State ZIP Code County Primary property owner contact name E-mail