Homestead_Smith (12)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D:PREPARER.:• . .-` . - _ . ,_ ; c . _
J. Robert Kinkle Attomey
Preporer o/the Salu Dbdosure Form Tlde .
PO Box 13. 219 N. Hart Streel Hall. Partenheimer & Kinkle
Addrev (Numberand So-eetJ Company
Princeton.IN 47670 812-386-0050
Ciry, Smt4 and ZIP lode Telephone Number E-mail
E: SELLER S .GRANTOR S -.' ', ° �'
.IaT,nr A Miller J. Michael Miller
Seller 1- Name as oppmrs on ronveyonceCxument Seller 1� Name as appevrs an ronveyanre dacument
21fi9 N. 350 E 2169 N. 350 F.
Address (Number ond Stree[J Add�ecr (NUmber and StreetJ
Princeton. IN 47670 Prinr.eton. IN 47670
Under penaldes of perjury, t hereby cerdfy [hat this Sales Disclosure, ro th b t of my knowledge and belief, is [rue, correct
�omplete as reqpired by law, and is prepared in accordance with IC 1 Property Sales Disclosure Act".
�- l��.2�, �
Slg 'ea(Seller Slg reo( elle
Javne A Miller �—� ����� � 2D I
M meo e er 5/ nDate NM/DD PrinredNameo Selfer an te(MM D
. BUYER S GR;4NTEE �-='APPLICATION FOR PROPERTY TAX:DEDUGTIONS-,IDENTIFY ACL ITEMS THAT AP.PLY ," ,; •; `�
T r A. mith
Buyer I- Name as appeo m m�veyanre domment Buyer 2- Name as appmn on ronveyonce document -
1 s er Streei
Address (Number and StreetJ Address (Number and SveeQ
FoA Branch. IN 47648
[
Tele honeNumber E-mall
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERT.II.Y DEDUCI'IONS FOR THIS PROPERTY. IDENTIN ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONORION
� ❑ 1. Will this property be the buyer's primary � ❑ 3. Homestead
residence? Provide complete address of prima 4. Solar Ene atlng/Cooling System
residence, including county:
7169 N. 350 E. ❑ ❑✓ 5. Wind Power Device
Addrcss(NumberandStrretJ ❑ � 6. Hydroelectric Power Device
Princeton.IN 47670 Gibson � � 7.Geothermal Energy Heating/Cooling Device
Clry, Smre ZIP Code Counry
� ❑ 2. Does the buyer have a homestead in Indiana m be � � $• �s this property a residential renWl property?
vacated for this residence? If yes, provide ❑ � 9. Would you like to receive [ax statemenu For this
complete address of residence being vacated, property via e-mail? (Provide contact information
including county: below. Please see instructions for more informa[ion.
t04 E. Foster Street Notavailable in all coundes.)
Address(NumberondStreet) �G ^ ns � � ]�Q � vGsl Sda-o,�7
Fort Branch IN 47648 Gibson Teresa R. 5mi�h °�
llry, Sm[e ZIP Code Counry
PAmaryproperryownercanmc[name E-moil
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