Homestead_York INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Kathy Masterson KATHY MASTERSON
Preparer of the Sales Disclosure Form Title
501 Main Street,Suite 101 Bosse Title Company,LLC
Address(Number and Street)
E-mail
E.SELLER(S)/GRANTOR(S)
Brittany M.Krohn Brandon L.Krohn
Seller I-Name as appears on conveyance document Seller 2•Name as appears on conveyance document
205 S.Sixth Ave. 205 S.Sixth Ave.
Address(Number and Street) Address(Number and Street)
Haubstadt,IN 47639 Haubstadt,IN 47639
City,State,and ZIP Code City.State,and ZIP Code
bkrohn@boemortgage.com
Telephone Number Email 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".
Signature of Seller Signature of Seller
Brittany M.Krohn 09/23/2020 Brandon L.Krohn 09/23/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/Yl'YY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Larry D.York /� Kristy J.York
Buyer l-Name as appears onronveyancedocument IS
// i..y Buyer 2-Name as app ears on con vyance document
y 3 3 3—f boy d (3rol
Address(Number and Street) ,/
L Address(Number and Street)
0i..) 1-WI e�6) .7-1 ii?4,66 Haubstadt,IN 47639 ®)pjJeu151/d)e- j/V iiLoS
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 1.Will this property be the buyer's primary ,,., El3.Homestead • OCt 08 2020
residence? Provide complete address of primary
residence,including county: ElEK 4.Solar Energy Heating/Cooli
❑ (V 5.Wind Power Device GIBSON COUNTY AUDITOR CB
205 S.Sixth Ave. ❑ 6.Hydroelectric Power Device
Address(Number and Street)
❑ [V 7.Geothermal Energy Heating/Cooling Device
Haubstadt,IN 47639 Gibson ❑ EK 8.Is this property a residential rental property?
City,State ZIP Code County
❑ ❑,9.Would you like to receive tax statements for this
4 ❑ 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:
e'er b. 3 -S-e
Address(Number and Street)0�an,S J.!/e . ...1) g7t,6s'-GI 1A.. 26-19 31-400 000.699 009
City•State ZIP Code 0 7 County Primary property owner contact name E-mail
•
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