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1\DU\p5.1LESDISCLOSUREFORM SDFID SDOID 469892 Page2 .
D.PREPARER - � -
Patti Kolb Closing Manager
�R'eyarerofrhe Scles Disdosvre form Title
226 W Broadvray Broadway Title, Inc.
AdJress /,Vum4e� undSUeeQ Compony
Pnnceton, IN 47670.
E. SELLER S /GRr1NTOR S -
Craig A Kuester
Srllerl �Nomeusappmrsomm�veynnaeJ«umem y�llerl-Nameasuppron. onannnwnredoaurnnt
704 N Lincoln St.
Addrese/NumberandSVreQ qddras(NUmberand5vcrt]
Fort Branch, IN 4764&
Cig: Smtq
E�mai! Tele oneNUmbcr E-moi!
Under penalties of perJury, 1 hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, rorred
and complete as required by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure AcC.
--G� A. %l�r�"_.
Signamre o/SA�er Signomre nf5eller
C�Za�v L�. i< T-cr2 a� 1� Zoio
�
F.B ^ �GRANTEES -APPGICA FORPROPERTYTrUCD S-1DEN LITEMSTHATAPPLY �
icnaei.Charles DEWl DonaldRDewig
Bu)erl�Nameasappmrsomm�v nred uyer2�NOmeasappevrsonm ewnaedorumen[
a00 E i son .
Addrea(A'umbermd5veetJ AEdress(,vumberand5nee�)
Haubstadt, IN 47639- Haubsiadi, IN 47639-
Ciry, Sm[a ondZlPCaEe /� / Ciry, Smce, ond ZIPCode j /
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E-moil
THE SALFS DISCLOSURE FORM MAY BE USED TO APPLY f0R CERTAIN DEDURIOYS FOR THIS PROPERiY. IDEM'IF1' ALL Oi THOSE THAT APPLY.
YES NO CONDRION YFS NO CON�ITIOY
X� � 1. Will this property be [he buyer's primary QX � 3. Homestead
residence? Provide complete address of primary � � 4, Solar Bnergy Heating/Cooling System
residence, including couniy:
t0a N LINCOW ST. ❑ Q 5. bVind Power Device
AAdrezs(NUmberandSUtt[) � Q 6. Hydroelectric Power Device
Fotl Branch, IN 47648 GIBSON � � 7. Geothermal Energy Heatlng/Cooling Device
Ciry. Sruu ZIPCode Caenry
�� 2. Does the buyer have a homes[ead in Indiana to be � �$� �s this property a residential renral property?
vacated for this residence? If yes, provide ❑ Q 9. 4Vould you like to receive tax statements for this
complete address of residence being vacated, properry via e-mail? (Provide contnct information
induding county: belmv. Pleasesee instrucrionsfor mor-e in(ormation.
Not available in alI coun[ies.J
Addresr (A'um6er an.d 5'vrrt]
Ciry.SmteZ/PCode Covnry � /�/��a�'aD� �I���
Rimarvpmperryo�mermr.matnume 6'-mail
Under penalries of perjury, I hereby certify that this Sales Disdosure, to [he bes[ o(my knowledge and belie(, is true, correct
and wmple[e as required by law, and is prepared in accordance with IC 6-11-S.S, "Real Property Sales Disclosure AcC. (Yote:
Spouse inform o, So„cial Se�rity and Driver's License/Other numbp�s are not necessa if no Ho estead Deductlon is
being filed.] � ���� � L\ n ry •
�// ., / R� C��'�-e'�� p% �� . �
Sigm[urt Bu�rrl Sign mreo/Bv}�er1/S use
� � a � l�
Sociol5ecuriryNum6er Los[SdigiaofBuyer2/SpouseDnveh Smte LastSDir�imafSocie(Secunty
Ute¢ve/ID/OtherNumber Number Lirense/lD/OrhenYumber