Homestead_KimmelINDIANA SALES DISCLOSURE FORM SDF ID: 2012
D. PREPARER
SE Martin Luther Kino Jr Boulevard
Indiana
E. SELLER(S)/GRANTOR(S)
Casey L. Caringer
Seller 1 - Name as appears on conveyance document
-2 4thStreer— a5y5 W. JILL-,
Address (Number and Street)
Frew�a64� +finnre -7in TA/ q % lo? C
City, State, and ZIP Code
E -mail I Telephone Number E -mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with �iIC�i66-- X11.1 -5.5, "Real Property Sales Disclosure Act ".
Ct�%t rn
4 i ah l ( Pa cal-i gy
n of Seller r�1t gnature of Seller
asey L. Car Jocelyn Nicole Caringer n 5- It /Q - CL
Printed Name of Seller Sion Date (MM/DD/YYYY) Printed Name of Seller Sion Date (M,Y1/DD1YYYY)
F. BUYER(S) /GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL ITEMS THAT APPLY
Steven A. Kimmel
S
ciscv `f 7&V
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E -mail
Beverley A. Kimmel
Buyer 2 - Name as appears on conveyance document
211 5, Sheet&
Address (Number and Street)
IN F= -d n LC5 C D `l 7(0 5r 9
City, State, and ZIP Code
(
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
❑ 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
211 S Fourth Street
Address (Number and Street)
Francisco, IN 47649 Gibsori
State ZIP Code County
❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide complete
address of residence being vacated, including county:
9058 s /o
Address (Number and Street)
2 /✓- 4`7� 5 c �sorc
City, State ZIP Code County
®'
❑
3 Homeste_a_riJ
❑
Q'
4. Solar Energy Heating /Cooling System
❑
5. Wind Power Device
❑
0
6. Hydroelectric Power Device
❑
i
8
7. Geothermal Energy Heating /Cooling Device
❑ 13 8. Is this property a residential rental property?
❑ :d 9. Would you like to receive tax statements for this
property via - email? (Provide contact information
below. Please see instructions for more information.
Not available in all counties.)
Primary property owner contact name E -mad
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and
complete as required by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note: Spouse
info ion, Social Security and Drivers 'cense /Other numbers are not ecessary if no Homestead Deduction isbeing fil .)
nature of Buyer I ` Signature of Buyer pouse
Steven A. Kimmel Beverley A. Kimmel
Print Le al ame of Bu er I Sign Date (MM/DD/YYYY) Print Legal Name of Buyer 21Spouse Sign Date (MMVD/YYYY)
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Last 5 digits of Buyer I Drivers State Last 5 Digits of Social Secunty Number Last 5 digits of Buyer 2 Drivers State Last 5 Digits of Social Security Number
License/ID/Other Number License/ID/Other Number