Homestead_Sanders INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
'.D:'PREPARER .1 ..` s s_ =`_''.. .'"`,,._` `.k . .C` ,:-
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Fomi Tide
PO Box 13, 219 N. Hart Street Hall, Partenheimer& Kinkle
Address(Number and Street) Company
Princeton, IN 47670
City,State,and ZIP Code Telephone Number E-mail
E!,SELLER(S)%GRANTOR(S),. . '.' _.`,-, -c = s .i%_# -c.',' i .. , :A4( ., t,. .-.1:' !..11-_1--:-' '
The Amended Richard I Wagner Revocable I lying Trust I- :u-..-• :' .. • . .•.- t- • -• - ' '•. .
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1446 N Kama Drive 770 S 150 E
Address(Number and Street) Address(Number and Street)
La Porte IN 46350 Princeton IN 47670
City,State,and ZIP Code
E-mail
Under penalties of perjury,t hereby certify that this Sales Disclosure to the best of my knowledge and belief,is true,correct
an- complete as required by law,and is prepared in accordance wi I 6-1.1-5.5,"Real Property Sales Disclosure Act".
--40 _A- L .
Signaturea - S tore of Seller
Kathryn Sommer Successor Trustee O4( I /2013 John B Wagner Successor Trustee Xi ( /9013
Printed Name ofSeller Sig ate(MM (M
/DD/YYY11 Printed Name ofSe er Sign Date .N/DD/YYn1
,F.': _ • r - • EE(S)=APPLICATION FOR PROPERT.YTAXi DEDUCTIONS=IDENTIFY=ALI.'ITEMS THAT APPLY <`, l_ :_
Buyer I-Na •.pears on conveyance document Buyer 2-Name as appears an conveyance document
60 k,,;an•e Street
Address(Number and Street) Address(Number and Street)
Oblong,IL 62449 _ __
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION __YES-- NO CONDITION _
Q ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of prim.. 2 r •
Heating/Cooling System
residence,including county:
❑ !9
1254 S 100 E • 5.Wind Power Device
Address(Number and Street) ❑ z 6. Hydroelectric Power Device
Pr.2n,:ptnn IN 47670 Gibson ❑ 171 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ Q 2. Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ El 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below. Please see instructions for more information.
q
Not avail e in all counties.)
Address(Number and Street) ogak7_,2 do_ 00a. O /3 -oa'/
Terry R.Sanders
City,State ZIP Code County
Primary property owner contact name 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 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
bein
Sign e of Buyer l Signature of Buyer2/Spouse
Terry R Sanders 01/ /2013
Number License/ID/Other Number