Homestead_Wilzbacher�
INDIANA SALES DISCLOSURE FORM SDF ID: �PaRe�2 j
D.PREPARER - ' -
J. Rabert Kinkle Attamev
�reparerof[heSa/aDirdosvreForm 77f1e
� Boz 13 219 N. Hart St. Hall. Partenheimer & Kinkle
��Addre¢(Num6erandStreet)
Seiler I� Name as appeors on ronveyanre docvmmt
Addres (NUmber ond 5[ree[J
. � . _ `�:i?.�c`� . .. ' .
Selier 2� Name asappears on �onvryvn[e document
Addre.s /b'umber oM 5[rret)
Ciry, Smte, and Z/P Code
Under penaldes of perjury, l hereby certify that [his Sales Disclosure, [o the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-11-S.S, "Real Property Sales Disclosure AcP'.
��/ � ���
SignoNreofSeller �� I SigncNreojSeller
.4�ma� �amPy 09/26/2011
o.:,,..eu„m..,tr.n.. n.,.,n,...iuvinmm�� nd.r.nx„me..�c.n.. c�,..,n�.vivvinniwrn
Avonne Wilzbacher Trusi u/a May 11 1994. as amended
By�er 1� Name as oppears om m�veyance dacvmm[
PO Box 95
Addres (A'umbu arM Stree[J
vbstadt IN 47639
�,
Buyrr Z- Nome as appearson ronveyvnce domment
Add: ess (Number ond StreetJ
Ciry, Smte, and ZIP Code
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIY DEDURIONS FOR THIS PROPERTY. IDEMIFY ALL OF THOSE TNAT APPLY.
1'FS YO CONDITION
Q � 1. Wil] [his property be the buyer's primary
residence? Provide complete address of primary
residence, induding counry:
525 W 1200 S
Addres (NUmber m+d Street)
Haubstadt IN 47639 Gibson Co.. IN
Ciry, Stare ZfP Code [ounry
Q� 2. Does the buyer have a homes[ead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
118 S Weber Dr
. Addrrss(NumberanARreeq
'Haubstadt IN 47639 Gibson Co.. IN
- Ciry.Smte2lPCode Caunry
�
�
�
�
�
�
�
❑./
❑✓
❑✓
�
❑.�
3. Homes[ead
4. Solar Ener� Heaeng/Cooling System
S. Wind Power Device
6. Hydroelecp-ic Power Device
7. Geo�hermal Energy Heating/Cooling Device
6. !s [his property a residential renWl property?
Q✓ 9. Would you like to receive tax staCemenCS for [his
property via e-mail? (Provide contact injormonon
6elow. Please see instructions for more informafion.
Not availa6le in all counties.J
a�-zZ-�s-Z�� �o9��y
The Avonne Wilzbacher Trust
ronWaname
Under penalties o(perjury, l hereby certify [hat [his Sales Disclosure, [o the bes[ of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-S.S, "Real Property Sales Disclosure Ac[". (No[e:
Spouse information, Social5ecurity and Drivers License/Other numbers are not necessary if no Homestead Dedudion is
be/in�dg filed.) (�/`
l A��- � 1 1� w[A�FP
�namre ofB�yerl Signamre a(Buyed/Spause
Lasi 5 d(qi[s of Buyerl/Spouse Driver's Sfate Last 5 Digits o(Sacial5ecunry
Number License/ID/OtherNumber