Homestead_Martin (21) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Pam Hancock Closer
Pre parer of the Sales Disclosure Form Title
221 NW Fifth Street Lockyear Title, LLC
Address(Number and Street)
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E.SELLER(S)/GRANTOR(S)
Jerry A. Greubel Dana J. Hallam
Seller 1-Name as appears on conveyance document Seller 2-Name as pears on conveyance document
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Address(Number and Street Ad ress(Number and Street) r
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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 complete Is required by law,and is prepared in accordance with-i.CC6-1.1-5 5,,;' eal Property Sales Disclosure Act".
Safrture of Seller Signature of-Seller C
err A. Greubb J j2a3/ O0D Tana 1 Hcafarli /02A3420
Printed Nettie 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 ITEMS THAT APPLY
Trevor Martin I
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
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Ad ess(NumberandStreet) Address(Number and Street)
4-1 0.w10S-1-10& TN) 4-1(03q
E-mail Telephone Number Dec 28 2020 E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. -
YES NO CONDITION YES NO CONDITION ,l/"w�•,;��+��f�f+��
❑✓ ❑ 1.Will this property be the buyer's primary ❑✓ ❑ 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary ❑ ❑✓ 4.Solar Energy Heating/Cooling System
residence,including county:
1 1 5 Roo(�,t 1 F' ❑ ❑✓ 5.Wind Power Device
hAddre (Number dStreet) ❑ ❑✓ 6.Hydroelectric Power Device
0.1 -1 -t- �P� 4 7 CQ 31 6 i bon ❑ ❑✓ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
[� ❑ 2.Does the buyer have a homestead in Indiana to be E 8.Is this property a residential rental property?
vacated for this residence? If yes,provide '0 ❑✓ 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
below.Please see instructionsfor mare information.
i Rr 2 including county: f
5 3 c LA J kr're..A1.-t-0y 1 - Not available in all counties.)
trljtlresUN`tuber nd 5 e t) 7�
tilleddr 'T i 1 CQ rL cSb n 26 23-16-200 002.020-024
City,Jtate ZIP Code County
26-23-16-300-000.867-024 Primary property owner contact name E-mail
ID/Other Number
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