Homestead_Cox (7)SALES UISLLUSURE FURM
Preparer of the Sales Disclasure From
Address (Number and Street)
SUP It):
Tide
Hall. Partenheimer & Kinkle
E -mail
E.
Cletus A Cox
Seller1 Nn�yTpearsonconveynncedocvment
Address (Number and Street)
Oakland City IN 47660
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 b� law, and is prepared in accordance with IC 6- 1..1 -5.5, "Real Property Sales Disclosure Act ".
Signature ofSelle, I Signature o /Seller i
ITEMS THAT APPLY
Buyerl -Namr - rs on conveyance dorument I Buyer2Nomeas oppearson
Address (Number and Street) Address (Number and Street)
Francisco IN 47649 Francisco IN 47649
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSEKIIAT APPLY.
❑✓ ❑ 1. will this property be the buyer's primary
residence? Provide complete address of f
residence, including county:
652 C SR 57
Address (Number and Street)
Oakland City IN 47649 Gibson
Cirv, State ZIP Cade 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:
Address (Number and Street)
City. state
County
FES NO CONDITION
❑✓ ❑ 3. Homestead
Heating /Cooling System
❑
❑✓
S. Wind Power Device
❑
❑✓
6. Hydroelectric Power Device
❑
❑✓
7. Geothermal Enere ' g /Cooling Device
❑
❑✓
8. Is this _ rty a residential ntal roperty?
❑
✓
❑
I e re 've x s tements for this
P p
v ? v c r actinformation
elow. Please see inst ructionsforreinformation.
Not available in all counties.)
aol �
Aron C. & Casey L. Bedivell
name E -mad
Under penalties of perjury, 1 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 -S.S, "Real Property Sales Disclosure Act ". (Note:
Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
being.)
Signature of Buyerl Signotore o) uyer2 /Spouse
C
asey l Pd yel 12 -16 -2011