Homestead_Ash (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Lana Harper Escrow Officer
Preparer of the Sales Disclosure Form Title
5231 Oak Grove Road,Suite A Total Title Services,LLC
Address(Number and Street)
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Janice A.Pohl
Seller I-Name as appears on conveyance document Seller2•Name as appears on conveyance document
152E BOO S
Address(Number and Street) Address(Number and Street)
Fort Branch,IN 47648
Telephone Number E-moll Telephone Number E-mail
Und•r penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true, correct and
cQ �'.lete as required bylaw and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
44
'gnaw of Seller �- Signature of Seller
Janice A.Pohl 10/20/2020
Printed Name afSeller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)k'�? T ,n !,b'rca A. w, .( �IQrI -PU r ? tTT Et7fi I6E T T'rµ� 3 ( a v
.< '�.c,. '�.?''a°^-�,�. :�rU•
Lyle N.Ash
Buyerl-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
152 E 800 S
Address(Number and Street) Address(Number and Street)
Fort Branch,IN 47648
City,State,and ZIP Code CIty,State,and ZIP Code FILED
(
E-mail Telephone P Oct 29 2020 E-mail
THE SALES LOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY LL OF THOSE THAT APPLY.
YES NO CONDITION YES O CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary ❑ El 4.Solar Energy Heating/Cooling System
residence,including county:
/r ❑ E5.Wind Power Device
WCJCJ ❑ El 6.Hydroelectric Power Device
Address(NumberandStree
❑ ❑X 7.Geothermal Energy Heating/Cooling Device
T:64'
j j ,
L/7( El, / L(� ❑ 8.Is this property a residential rental property?
Cillyy,State,and ZIP C County
❑ 0 9.Would you like to receive tax statements for this
El2.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
Address(Number and Street)
26-19-19-203-001.272-026
City,State and ZIP Code County Primary property owner contact name E-mail