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Homestead_Green (3)INDIANA SALES DISCLOSURE FORM SOF ID: Pa e 2 D.PREPARER J.RObert Kinkle Attornev R'eyurer o(the Safa Disdwure Form Title �219 N. Hart St.. PO Box 13 Hall Partenheimer & Kinkle Addras (Number ond StrxQ Lompany Princeton IN 47670 E-mail E. SELLER S GRANTOR 5 Darius A_ Plank Seller ]� A'ome as apprors om m�vqnnce docvmmt Seller I� Nume os apyenrs om m�vevonre dxummt 232 E Baird St_ Aot B Address (Humber and Sveet) ddd�os (NUmber ond5[rmt) West Liberty OH 43357 Emnil Tele honeNumber Email Under penalties of perjury, 1 hereby certify that this Sales Disdosure, [o the best of my knowledge and belief, is true, correct and comple[e as requir d by law, and is prepared in accordance �vith IC 6-1.7-5.5, "Real Property Sales Disclosure Act". �.� �. ���. Signamre o/Selle� Signalure o/Seller Darius A Plank 12-23-2011 PnntedNameofSel/er SiYnpa41.V11/DDMI PnnteJNameo(Sel/er Sipnlbte AH/DO/YY1 F. B EE S- APPLICATION FOR PROPERTY VFS NO LOYDITION YFS Q � 1. FVill [his proper[y be [he buyer's primary I ✓ � 3. Homestead residence? Provide complete address of primary rgy Heating/Cooling System residence, induding counry: 1124 S. Gibson Street ❑ Q✓ 5. Wind Power Device Address(Num6erand5treeQ ❑ ❑J 6. Hydroelectric Power Device Pnnceton IN 47670 Gibson � Q 7. Geo[hermal Energy Heating/Cooling Device Ciry. Smte ZIPCode Cmmry �✓ � 2. Does the buyer have a homes[ead in Indiana [o be � �$� �s this property a residential rental property? vacated fm� this residence? If yes, provide ❑ ❑� 9. Would you like to receive tas statements for this complete address of residence being vacated, property via e-mail? (Provide rontod informotion including coun[y: belo�v. Please see instructions for more information. 10149 S. Koich Drive Not a��a/il'able in aAll rount�s.J Address(Num6erondS:reef) a�i/a ��'�j�13'o(/a.� � Q�� PoSeWille, IN 47633 POSeV Larry E. Green 8 Dottie K Green Ciry, Smte ZIYCode Counry Pnmory ymperry o�vner mnmr: nnmr E�mail Under penal[ies of perjury, 1 hereby certify [ha[ this Sales � �