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HomeMy WebLinkAboutHomestead_Williams (38) • • INDIANA ALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER, " .. I • - - J. Robert Kinkle Attorney Preparer of the Sales Disclosure Form Title PO Box 13, 219 N. Hart Street Hall, Partenheimer&Kinkle Address(Number and Street) Company Princeton. IN 47670 812-386-0050 City,State,and ZIP Code Telephone Number E-mail 'E:SEL•LER(S)/GRANTOR[S)• ': . - ', '- , . 4 C's Inc Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 4350 N.Trippet Rd. Address(Number and Street) Address(Number and Street) Patoka, IN_47666 Telephone Number Email Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complet as re ired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of S le ,, / Signature of Seller Richard Jeffrey Clark President t // `3 Printed Name ofSeller Siaf,Date(MM/DD/YYYY) Printed Name ofSeller Sian Date(MM/DD/17Y11 F. BUYERS)/GRANTEE(S);4'APPLICATION-FOR PROPERTY TAX'DEDUCTIONS--IDENTIFY AELLITEMS THAT APPLY , Adam M. W'lli�� Lauren Ann Clark ,wn as appears on conveyance document Buyer 2-Name as appears an conveyance document 715 5.Old Patoka Rd. 715 S. Old Patoka Rd. Address(Number and Street) Address(Number and Street) Patoka, IN 47666 - __ Patoka. IN 47666 City,State,and ZIP Code City,State,and ZIP Code Telephone Number Email 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 Y • • ❑ 1.Will this property be the buyer's primary TIT IZ 3. Homeste.• residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 8 Finch I one El 15 5.Wind Power Device Address(Number and Street) ❑ Q 6. Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 0 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 ❑ 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 or more information. e m all counties.) Address(Number and Street) 04- - o ' - Loo _ 003.3 8?-0a8 Adam M.Williams&Lauren Ann Clark City,State ZIP Code County rimary property owner .-r• • - E-mail