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INDIANA SALES DISCLOSURE_FORM SDF ID: Page 2
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Lana Harper - Escrow Officer �- -} —
frcpmer oldie Sates-aidesereFone Title --. _ _.
5231 Oak Grove Road,Suite A Total Title Services,LLC
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+ Ii SELE,ER(SJ f G1tAJ11TOlt(S� ----- — -
John G.Konen,as Trustee of The Meagan E.Bates Irrevocable Living
' Trust
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SeAerl3850 State Rd 39
Addrn (Nam and
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_Martinsville,IN 46151
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Under pules of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and bellel.is true,correct and
complete as required by law,and is prepared hi accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Printed Name*Mellor SteDatetleee/DO)YYYYJ MetrdNoa»ofSe Malt DOI(NM/UD/Ws'►?
F_RUYER(S)./GRA TEES)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Travis C.Johnson — Elizabeth G.Johnson
Buyer 7-NameQrrppearsanea dFseaseatt — Bayer 2•Nam as appears o+reomrgymreedocument — -
9921 W 575 S ' 9921 W 575 S
Mien INamter and Street) Address Member muttered)
Owensville.IN 47665 Owensville,IN 47665 FILED
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YES NO COMMON YES NO CONDSUON
M 0 L Will this property be the buyer's primary ot0 3.Homestead GIBBON COUNTY AUDITOR CB
residence? Provide complete address of primary
residence,including county: 0 ® 4.Solar Energy Heating/Cooling System
0 ElS.Wind Power Device
A -� r j( 5/C 3 - ❑ 0 6.Hydroelectric Power Device
Q,� ! �j ❑ ® 7.Geothermal Energy Heating/Cooling Device
irtrepiu
S(` e /N V745 eihi. ❑ 0 B.is this pea a residential
aasSt ewn,Coda ownty 1 property rental Prof
❑ ® 9.Would you like to receive tax statements for this
1 0 0 2.Does the buyer have a homestead in Indiana to be I property via e-mail? (Provide contact infirmatkm
vacated for this residence? Ifyes,provide below.Please see Instructions for more information.
complete address of residence being vacated, Not available in ail counties)
including county •
Agitates(Numb,7d"d _ 26-17-09-200-004.919-021