Homestead_Williams (39) INDIANA SALES DISCLOSURE FORM SDF ID: Page_2
D.PREPARER . - .
J. Robert Kinkle Attorney _
Preparer of the Sales Disclosure Form Title
219 N.Hart St.PO Box 13 Hall,Partenheimer&Kinkle
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050 jrkinkle @hpk-law.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
Habitat for Humanity of Gipson County Inc
Seller I-Name as appears on conveyance document Seller 2-Nome as appears on conveyance document
PC)Box 218
Address(Number and Street) Address(Number and Street)
Hauhstadt IN 47639
Telephone Number E-mail
Under pe !ties of perjury,I h- `by certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an co lete as r- r 'red by .w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller OS ,' Signature of Seller
David S Burke for Habitat for Humanity 7— /
Printed Name of Seller Sian Date(MM/DD/YYY1) Printed Name of Seller Sign Date(MSc/OD/YflYI
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY•. ' . .
mie L.Williams
rs on conveyance document Buyer 2'Name as appears on conveyance document
PO Box 213
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
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.
Ill
YES NO CONDITION YES w r11
n Nn TION '
Q El 1.Will this property ty be the buyer's primary Z ❑ 3.Homestead.
residence? Provide complete address of primary 2 4,Solar Energy Heating/Coolin SttsL
residence,including county: ❑ ❑ S.Wind Power Device �30-- r7U
214 Central Ave
Address(Number and Street) ❑ El 6.Hydroelectric Power Device e)
Princeton, IN 47670 Gibson ❑ E 7.Geothermal Energy He. a,; 7... i.. i,. OR
City,State ZIP Code County /
❑ ❑ 2.Does the buyer have a homestead in Indiana to be j9 8.Is this property a�g�§pritiSb �l 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 for more information.
Not available in all counties.)
Address(Number and Street)
A 6- 101 -/8 . 3oy - co/. Oao -o a. 5'
City,State ZIP Code County
Primary property owner contort 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
g filed.) �j
\ 7 /7Lt-( r- /Add J/ta, J
ignature of Buyer! Signature ofBuyer2/Spouse
Number License/ID/Other Number