HomeMy WebLinkAboutHomestead_SmithPreparer of the Sales Disclosure Form
119 N. Hart St. PO Box 13
4— (Numberand Street)
nnceton. IN 47670
City, State, and ZIP lode
E.
Seller 1 - Name as appears on conveyance document
Tide
Hall. Partenheimer & Kinkle
E -mail
Seller 2 - Nome as appears on conveyance document
1519 S 950 F 1519 S. 950 F.
Address (Number and Street) Address (Number and Street)
Oakland City IN 47660 Oakland City. IN 47660
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 -5.5, "Real Property Sales Disclosure Act ".
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signature ofseller �Stgnature o %Seller , / /�
rcncS nA,.r,.an /�i /9i7C0 KrieH nA Kara..
Buyer 1 - Nomeaki1ppears on conveyance document
Address (Number and Street)
THIS
THOSE THAT APPLY.
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❑
3. Homestead
V
4 Sola Heating /Cooling System
❑
F(
S. Wind Power Device
❑
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6. Hydroelectric Power Device
❑
Q
7. Geothermal Energy Heating /Cooling Device
❑
[Z]
8. Is this property a residential rental property?
❑
Q
9. Would you like to receive tax statements for this
property via a -mail? (Provide contact information
below. Please see instructions for more information.
Not available in all counties.)
- ,? -doo -QUO 606
Caleb
E. Smith
Primary property owner contact name E -mail
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 -5.5, "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 filed.) I -
VILture of Buyerl /
rolch F Smith