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WQIANA SALES DISCLOSURE FORA SDF ID:
Page 2
D.PREPARER
Val J. Fleig Attorney
Preparer of the Sales Disclosure Form Title
North Ninth Street Val J. Fleig Law Office
ddress (Number and Street) Company
Petersburg, IN 47567 (
City, State, and ZIP Code Telephone Number Email
E. SELLER(S)/GRANTOR(S)
Martha L. Horrell
Seller] Name as appears on conveyance document
Seller2 Name as appears on conveyance documeor
402 W. Pike Avenue
Address (Number and Streec)
Address (Number and Street)
Petersburg, IN 47567
City, State, and ZIP Code
City. State, and ZIP Code
(
E -mail
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 cg t letea*ey�d b y I��repared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
-
Slgna1re of Seller Signature of Seller
Martha L. Horrell
Printed Name of$eller Sian Date IMMyDD/YYYY) Printed Name p Seffer Sian Date (MM /DD
F. BL ' S1 - APPLICATION FOR DEDUCTIONS AND CRED] I IFY AL THAT APPLY
Iartha L. Horrell
Victoria L. Ross
Buverl Name as appears onconv .,ce document
Buyer 2- Name as appears on conveyance dog ment
enue
or on
Address (Number and Street)
Address (Number and Streer)
Petersburg, IN 47567
Oakland City, IN 47660
®
E -mail
Telephone Number Email
TILE SALES DISCLOSURE FORM bIAY DE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
x1 ❑ 1. Will this property be the buyer's primary
] ❑ 3. Homestead
residence? Provide complete address of primary
❑ xD 1. Solar Energy Heating /Cooling System
resilience, including county:
❑ f� 5. Wind Power Device
210 W. Morton
❑ 7x❑ 6. Hydroelectric Power Device
Add,,.(NumberandStreet)
Oakland City. IN 47660
❑ �xx] 7. Geothermal Energy Heating /Cooling Device
E) 8. Is this property a residential rental property?
Ciry, State ZIP Code County
❑ 7x] 2. Does the buyer have a homestead to be vacated for
this residence? If yes, provide complete address of
residence vacating, including county:
_
ovo -
Street)
Address (Number and
Ciry. Sm to ZIP Code County
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and co iplete re it y law, an s prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
✓��
Sir.oture of Buyer i Signs cure ofBuyer2
Martha L. Horrell Victoria L. Ross
Printed Name p Bated Sian Date (MMfDDIMY) Prin red Name p Buvert Sian Date lMM/DD/YYY11
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