Homestead_Anderson (5)INDIANA SALES DISCLOSURE FORM SDF ID: .. PaRe 2
D.PREPARER
Preporer o/ [he Sales Disclomre Forrn
219 N. Hart St. PO Box 73
'dress (Num6er and S[reet)
nceton, iN 47670
liry, Sm[e, ond ZIP Code
Seller ]- Name as appearsan ronveyonce dotument
Addres (Numherond SveerJ
Owensville. IN 47665
Ciry•, Stote, and ZIP Lode
/
E-moil
TiHe
Hall. PaAenheimer & Kinkle
Compan�•
E-rnoil
Seller 2- Name os oppears m� ronveyance documen[
AJdress (Number and 5[rcelJ
Owensville. IN 47665
City, Smte, and ZIP Code
Under penal[ies of perjury, I hereby certlfy that this Sales Disdosure, to the est of my knowledge and belief, is true, correct
an/d c�omplete a�s Jrequised by law, and is prepared in accordance with IC -.1-S.S;fReal Property Sales Disclosure AcY'.
//�ln._t�i+��C t"3� . :� X
� iignaNr f5e r � ignomreo(Seller
F.
Buyer 1 � Name os
Addres (Num6eraid StreeO
PnnteJ Nome
-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
do�umrnt
Theresa K. Anderson
BWer 2- b'ame as appearson ronreryvnre dotument
3803 S.700 W.
Addres' /Number unJ Street)
Owensville. IN 47665
,Ciry, Smte, and ZlP Cade
THE SALFS DISCLOSURE FORM MAy BE USED TO APPLY FOR CERTAIN DEDURIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TFUT APPLY.
NO CONDITION
0 ❑ 1. Will this property be the buyer's primary
residence? Provide complete address oFprimary
residence,including county:
�486 G 550 W
Addres (Num6er and 5[ree[J
Owensville IN 47665 Gibson
Ciry, Stule ZlP Code 'Counry
� ❑ 2. Does the buyer have a homestead in indiana to be
vacated for this residence? If yes, provide
complete address oF residence being vacated,
induding county:
3803 S.700 W.
Addrea (Num6er and Stree[J
Owensville, IN 47665 Gibson
Ciry, Smre ZIP Cade County
� ❑ 3. Homestead
❑ � 4. Solar Energy Heatlng/Cooling Sys[em
❑ � S. 4Vind Power Devi[e
❑ 0 6. Hydroelectric Power Device
❑ � 7. Geothermal Energy Hea[ing/Cooling Device
❑ �✓ 8. Is [his property a residential rental property?
❑ � 9. Would you like to receive tax statements for this
property via e-mail? [Provide conmct injormation
below. Please see instructians for more information.
Nat available in all counties.)
at�-i�-a9-���,� oa�
John E. Anderson
awner conmcr name
E-moil