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1\DIAN,\ SAL:S DISCLOSURF, FOR�I SDF ID SDO ID 677630 Pa�e2
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Crista Wallace Typisi
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005 S. E. Martin Luther King Jr. Blvd. Southwestern Indiana Land Tille
AdAress(AYnnberond5�n+rQ Comyvny
Evansvile, IN 47773-
E. SELLER S GILINTOR 5
Richard W. Griffin Jr. PAarianne Gnffm
Stller 1-;:am,e as oppenrs on mm�eymire doammt Sel7er 2� Abme nc appmrs on rome��anre Aorvment
3433 Drover Lane 3433 Drover Lane
Addrrss (NmnberanES[m:J Addrcss (t:umber nnd Strxt)
Darien, IL 60561- Darien, IL 60567-
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E�mail Trle huneNumbrr E-rnail
Under penal[ies of perjmy, I hereby cer[ify that [his Sales Disdosure, m tlie best of m}' knowledge and belief, is true, correct
�an comple[e as m� uired bv la�+�, and is prepar -m acmrdance wi[h IC 6-1.1-S.S, " al P oper[}' Sales Dis w-e Att".
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�c: namreo(SrIlle���/ G�/'j���t T_ � �d �enamre-/Seller /` �" ��/ � /I
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S/GRANTEE S- APPLICATION FOR�PROPER � - Y.4LL ITEM11S THAT APPLY `
Cary R. Maurer Beth A. Maurer
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I.; en lake Drive ' .� den Lake Drive
Addrese (tiumAe� and Svnt] .AAEre.ca /kwnAer ano cv¢erJ
Ft. BranU, IN 476t& Ft Branch, IN a76�8-
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THE STLFS DISCLOSURE FORM AtA1' BE USED TO dPPLS FOR CERTAIK DEDUCTIO\5 FOR TH�S P20PERTY. IDE,YIIFI' dLl OF TNOSE TN,\T APPL\'.
YES NO COYDITION I � 0 CO\'pITIOR
Q � 1. Will this properiy be the buyer's primary QX 3. H
residence? Provide complete address of primary � � 4. Solar Energ}• Hea[ing/Coolino Systein
residence, including county: � �
8225 S. HIDDEN LAKE DRIVE S. l�Vind Po�ver Device
mmrc,:�,vu�„oe.ondsr.��r/ ❑ Q 6. Hydroelectric Pou�er Device
Ft. Branch, IN a76a8 GIBSON � � �. Geotliennal Encrgy Hcating/Cooling Devite
Cip•.SIn(eZlPCOde Comrrv
�X � ?. Does the buyer have a homestead in Indiana to be �1�I � $� Is diis property a residential rental property?
vacated for this residence? If yes, provide L! 0 9� �Vould you like ro receive tax statements for this
complete address of residence beino vacatzd, P��oPerty via e-mail? (Provide conmtt informntion
including county: below. Please see instruc[ions for more in%nnadon.
406 E.PLUPd STREET Not availnble in cJl coimties.)
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Haubstadt, IN 47639 GIBSON �- I�--r�-�{�'�^ �a . O � 7�t/ ��
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Under penalties o(perjury, I hereby certify tha[ this Sales Uisclosure, [o [he best of my kno�vledge and belie(, is true, correct
and comple[e as required by la�v, and is prepareA in accordance witli IC 6-71-SS, "Real Property Sales Disclosure Act". (\ote:
Spouse in(ormation, Social Security and Dri��er's License/OUier numbers are not necessan� if no Homestead Deduttion is
being filed.) _ -
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