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Homestead_Brittingham (7)
a INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 I) PREPARER R.Stephen LaPlante Attorney at Law Preparer of the Sales Disclosure Form Title 101 N.W. 1st St.,Ste. 116, P.O. Box 3556 LaPLANTE LLP Address(Number and Street) Company Evansville, IN 47734-3556 E-mail E SELLER(S)%GRAN.TOR(S)_. ' . f _: .; - __, . - - - •_- -. I.,._ _,' - . 7_ . :-- - : '' Stacy M.Wissel.Trustee Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document P.O. Box 68 Address(Number and Street) Address(Number and Street) Decker. IN 47524-0068 City,State,and ZIP Code City,State,and ZIP Code E-mail Telephone Number E-mail fit er penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct complete as req ired b law,a d is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Wg atu • • er Signature of Seller Stacy M 't�/a?4---_ -- i a f l i(1 %� ame o Seller Si n Dat Printed Name o Seller . f g ( / /YYY}� f Sign Date(MM/DD/YYYh 151j. YER(S):/GRANTEE(S) APPLICATIONF0 1 9•e RTYT7)\-DEDUCTIONS IDENTIFY ALL.ITEMS THAT'APPLY- Buyer 7-'' . (fr Frank A.Brittingham Marlene S. Brittingham Buyer 1-Name as appears on conveyance document 2-Name as appears on conveyance document 5078 N.775 E. 5078 N.775 E. r( /4 Address(Number and Street) / Address(Number and Street) Patoka, IN 47666 Patoka. IN 47666 City,State,and ZIP Code City,State,ar,...0.31raile --------------------.0C. 46:11) /Q 1 E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR TAIN DEDUCTIONS FOR THIS PROPERTY.ID S HOSE ' • YES NO CONDITION NO 0 CONDITION ��"VVVV C 1.Will this proper e buyer's primary �❑ p p y p ry ❑✓ ❑ 3.Homestead ,q� resideace2—P ovide complete address of• mary ❑ © 4.Solar Energy Heating/Cooling Sygt'a- residence,including county: ❑ 0 5.Wind Power Device R 5078 N.775 E. Address(Number and Street) ❑ IZI 6.Hydroelectric Power Device Patoka, IN 47666 Gibson ❑ E1 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑✓ ❑ 2.Does the buyer have a homestead in Ind na to be ❑ ❑✓ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Z 9.Would you like to receive tax statements for this i complete address of residence being vacate., property via e-mail?(Provide contact information including county: below.Please see instructions for more informatio . 5078 N.775 E. Not available in all counties.) Address(Number and Street) (� Patoka, IN 47666 Gibson a _ bLQ'�t. ` OD -Qo •"l - 1`1 City,State ZIP Code County Primary ertyyoownercontactname E-mail