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Homestead_Klem (2)
INDIANA SALES DISCLOSURE FORM SDF ID: 2020 Page 2 D. PREPARER Abbigail Moers 6:6 oeko L) Ifk Preparer of the Sales Disclosure Form Title 605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title Address(Number and Street) Company Evansville, Indiana 47713 ( E. SELLER(S)/GRANTOR(S) SIRE Holdings, LLC,an Indiana limited liability company Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 403 E. Strain Address(Number and Street) Address(Number and Street) Fort Branch, IN 47648 City,State,and ZIP Code City,State,and ZIP Code � E-mail 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 corn lete s req"red by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". v• % S' re of Seller. Signature of Seller /) p r 4--11/1 9/2020 11/19/2020 Prin ed Nam of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL I i IIT 'AT Aii L'' �' '-'1—I 11-00 Tammy Klem Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on convej p.1 document 401 S.Willard St. Iri BUJ�I Address(Number and Street) Address(Number and Street) Fort Branch, IN 47648 —nS� E-mail Telephone Number E-mail' THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. ItS7 NO CONDITION YE NO CONDITION El1. Will this property be the buyer's primary 1 ❑ 3. Homestead residence? Provide complete address of primary ❑ El 4. Solar Energy Heating/Cooling System residence, including county: ❑ El 5. Wind Power Device 600 S Lincoln St. Address(Number and Street) CIEl 6. Hydroelectric Power Device [Fort Branch, IN 47648 1 Gibson' 0 RI 7. Geothermal Energy Heating/Cooling Device City,State Code County ❑ © 8. Is this property a residential rental property? ❑ 2. Does the buyer have a homestead in Indiana to be 0 0 9. Would you like to receive tax statements for this vacated for this residence? If yes, provide complete property via-email? (Provide contact information address of residence being vacated, including county: below. Please see instructions for more information. Not available in all counties.) Address(Number and Street) X°"/?-15- /,I- oo0.388 -o a-4 City, State ZIP Code County Primary property owner contact name E-mail ID/Other Number