Homestead_Neukam INDIANA SALES DISCLOSURE FORM SDF ID: 2013 , Page 2
D. PREPARER
-
Melissa Prather Operations Manager
Preparer of the Sales Disclosure Form - Title
4206 Charlestown Road,Suite 100 Kemp Title Agency, LLC
Address(Number and Street) Company
New Albany, Indiana 47150 (812)941-8980 mprather @stewart.com
City;State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Justin W. Rumble
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10166 Eagle Crest Lane
Address(Number and Street) Address(Number and Street)
•
Elberfeld, IN 47613 ,
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
anlete as required by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". .
W• lei....
nature of Seller Signature of Seller
•
Justin W. Rumble C» lul'7(1\-
Printed Name of Seller Sign Date(ndM/Db/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F :• ' R(S)/ -.• TEE(S)-APPLICATION FOR PROPERTY T• i u UCTIONS -ID • y ALL ITEMS THAT APPLY
, Tiffan R.Wilkes Joshua K. Neukam
-r -• - -as appears on conveyance document - • - - •'-••= . .:.•yrs on conveyance document
89f 6 adState Roeff C4 X22 k------ (
Address(Number and Street) ` ``'' Address(Number and Street) • f i
�\rnd u -j, 114 flQ K) . • EckcRy, IN 4711G fl S(\MCI L( I T_W Alt a00
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR -:•-ERN. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION ' S NO CONDITION
1 ❑ 1. Will this property be the buyer's primary ( .IX- ❑ 3. Homestead
residence? Provide complete address of primary _ • A3 4. Sola •- .p eating/Cooling System
residence,including county:
❑ % 5. Wind Power Device
822 West Dr.
Address(Number and Stmt) ❑ cif 6. Hydroelectric Power Device
.
Oakland City, IN 47660 I Gibsori ❑ 2ii 7. Geothermal Energy Heating/Cooling Device
. .. .
City,Sat�tSSe ZIP Code , - � County ❑ � 8. .Is tfiis.property a residen5aLrental propeRj?_---
❑ K 2. Does the buyer have a homestead in Indiana to be ❑ S 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
// [�/NNot available in all counties.) '1
Address(Number and Street) - C/16 -/7 r r/ -/Pe-0 o-O'ya -do 2
17 rP,4uy R. &.o gc-s
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 n necessary if no Homestead Deduction is being filed.)
Signt• of Buyer nature of Buyer 2/Spouse
Tiffany R.Wlkes . 9-\\-■5 shua K. Neukam -7-M
3