Homestead_Kirby INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
121,PREPARER
Justin Woodruff Title Agent
Preparer of the Sales Disclosure Form Title
1532 Wabash Ave. Integrity Title Services, Inc.
Address(Number and Street)
United Minerals Company.I I C
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
701 Market Street,Suite 737
Address(Number and Street) Address(Number and Street)
St.I ouis, Missouri 63101
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 comf lete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
g ...... 4 C 13 4.11.
Signature of Seller Signature of Seller
Robert F.Bruer.Vice President 11/20/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
"f.8INERNIGRANTEE,(8t-_APPLICATI al,FQR,PRO_PErtrYTAitl)
R/. Z 1.Will this property be the buyer's primary 1V/ P 3
A .Homestead -
residence? Provide complete address of primary [1_1 111 4.Solar EneroA Nit& E#111410 R
residence,including county:
V 742 5-: //e o e- El z 5.Wind Power Device
Address(Number and Strot) . IDI 1Z 6.Hydroelectric Power Device
--01/i".-e/9 G."-) i /4/ 7.,(e a ‘ 0,7 0 RI 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 z 8.Is this property a residential rental property?
0 1I1 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide D z 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.
Not available in all counties.)
Address(Number and Street)
)‘(i 2^0 -01'-- X)t'-) —001
City,State ZIP Code County
Primary property owner contact name E-mail