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Homestead_Johnson (7) INDIANA SALES,DISCLOSURE FORM SDF ID: , , Page_3_ 0,API FP REtt'_, _- _' ..`. "� . . ..,.,_, .. . _ _..o__. .., - -,. _ John G.Wetherill Attorney Preparer of the Sales Disclosure Form Title 215 Main Street Wetherill Law Office,LLC Address(Number and Street) Company Rockport IN 47635 E-mail E„Sl LER[S/GItf1NTOk(S) . - - . Nathan M.Beloat Rachel R.Beloat Seller 1-Name as appears on conveyance document Seiler 2-Name as appears on conveyance document 2605 W 1025'S same Addreis.(Number and Street) Address(Number and Street) Ft Branch IN 47648 ) E-mail Telephone Number E-mail Under penalyt'es of perjury,I hereby ertify thatthis'Sales Disclosure,to the best of myknowled and belief,is true,correct and:compl e a quirefib 'iam, rid'- prepared in accordance wi 1.1-5. " "e op Sales Disclosure Act". ig rature fSer �O r na e,o Selle-- 1. eSA r.f Nathan M:Beloat /a0%dad Rachel R.Beloat /O ar7/a(c) Printed NameofSeller SIln,Date(WM/DDfYYYYI Printed Name ofSeller Srgn-Date{MM/DDAWY) F,l3UYERjrS`'GRANsTk}E S} '/11xPL1 Al li?N FOR PROP R(tY,I A'K L?E'DUC'i'1{iNS s11 CNsI 1F 1 L IT1J`MS`{I£1'A l A'PI� Y ,g f` .. _„> g Christopher L.Johnson Melissa D.Johnson Buyer I-Name as appears on conveyantedocument l3uyer 2-Name as appemirs on cons nceIL E D 536 Autumn Bluff Dr. same Address(Number and Street) Address(Number and Street) 0 2 2020 Ellisville MO 63011 NOV`�J Y �I E-mail Telephone Number �{�'����-{{��UU�jrOU TY AUDITOR THE SALES DISCLOSURE FORM MAY USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL op noSE'ruA rAPP YES NO CONDITION YES/ NO CONDITION ❑ 1.Will this propertybe:the.buyer's primary ❑ 3.Homestead residence? Provide complete address of primary 0 © 4.Solar Energy Heating/Cooling System r sidence,including county: ❑ ❑ 5.Wind Power Device C d ress(N ber and Street) p El 06.Hydroelectric.Power.Device , }•j- ck ^ n() - Lf - Li A ❑ fJ✓ 7.Geothermal Energy Heating/Cooling Device City,.StateZi Code County ❑ ] 2.Does the buyer have"a homestead in Indiana to be ❑ 0 • 8..Is this property a residential rental property? vacated for this residence? If yes,provide ❑ © 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: below.Please see instructions for more information. C/ Not available in all counties.) Address(Number and Street) At-1 S-3 te+-Lk 00-00 AS _Q!-4 City,State ZIP Code County E-mailPrimary.property owner contact name