Homestead_Kolb (4)DISCLOSURE FORM SDF ID:
J. Robert Kinkle
Preparer o(the Sales Dislosvre Form
219 N. HaA Slreet
res(Numberand5tree[J
,�iceton IN 47670
City. Smte. ond ZIP Lode
ThP Estate of Caml Jean Jnnes
Seller 1- Name asaVG�rs on ronveyanre documen[
10 Fin�h Lane
Address (Num6er arM Street)
Ciry. Smte, and Z/P lode
Telephone Number E-moil
r��e '
Hall Partenheimer & Kinkle
Compony
Seller 2- Nome at appears on ronveyvnre datumen!
Address (Number ond 5[ree[)
Ciry, Smte, and ZIP lode
E-mail
Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is lprepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act".
'r %! IGt�1 �P���tnY.�nJ
Signamre�� I SignomreojSeller .
Madene Ficher Unci�rvised Personal Re� 04-30-2012
Pnnttd Name o�5eller Sipn Da(e (MN/OD/1'YIM1�
FOR PROPERTY TAX DEDUCTIONS- (DENTIFY ALL ITE
Addres (Number ard SGeet)
P��oka. IN 47666
Smte, and Z1P fnde
�[-
Teleohone Number E-mail
Buyer 2� Nome ns apprars on �onvr}•nnce document
Addrea (Number and Stree[�
Ciry•, Smte, ond ZIP ('ade
Number
THE SALFS DISCLOSURE FORM MAY BE USED TO APPIY FOR CERTAIN DEOUCfIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
�✓ � 1. Will this property be the buyer's primary
residence? Provide complete address of E
residence, including county:
Addres (Num6er a rd 5[tre[)
Princeton IN 47670 Gibson
[iry, Smle ZIP Lode [ounry
Q� 2. Does the buyer have a homestead in Indiana to be
vacated for [his residence? If yes, provide
comple[e address of residence being vacated,
induding county:
2725-E. 400 N
'Addrea (Number and Stree[J
Patoka;IN 47666 Gibson
Ciry.Smre ZIP �nde Counq.
PES NO C
E mail
❑✓ ❑ 3. Homestead
�---�--43e rgy Hea[ing/Cooling Sys[em
� ✓� S. Wind Power Device
❑ �❑ 6. Hydroelectric Power Device
❑ 0✓ 7. Geothermal Energy Heating/Cooling Device
� �✓ 8. Is this properry a residential rencal property?
� �✓ 9. Would you like m receive tax statements for this
property via e-mail? (Provide contoct informotion
below. Please see instructians jor more informntion.
Not availnbi n all counties)
o?L-/�-oG•�joo•oa3. 7�7 a��
Sandra L. Kolb
ronmct name
E mail
Under penaldes of perjury, l hereby certify that [his Sales Disdosure, to the best of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure AcC'. (No[e:
Spouse informadon, Social Security and Driver's License/O[her numbers are not necessary if no Homestead Deduction is
beingfle/� I `�,i .
ai/ l�.�l�'
iNre of Buyerl SignoNrc o(Buyer2/Spause
Sanrira I Knlh 04-30-2012
Pnn[edLegolA'qmeo(Bm�erl SignDote(MM/UD/vV1'1j PrintNLegalNnmeojBuyer2/Spouse SignDate[MU/UD/�TVY)
� /
Los[ 5 digiGS o/Buye�l Dnver's Sta[e Lost 5 Digi4r ofSocial5ecuriry Num6er Las[ 5 digits of Buyer2/Spouse Dnver's Smte Last 5 DigiGS o�5ocial Security
Lirense/ID/OLherNum6er Num6er Lirense/ID/0[herNumber