Homestead_Obert (7)INDIANA SALES DISCLOSi1RE FORM•
_ . . .--- - �. .. .. ,�. -� - _ . ,..,. .._ . , _, . -r-x. .... .
J. Robert Kinkle Attornev
Preporer o/[.ke Salu DBrlosure Farm Title
�°,O Box 13. 219 N. Hart St.
�r.xr (Number and SveetJ
F'r�ceton, IN 47670
Ciry, Sm[� and ZIP Cade
BPrnard A. l ub. TnistPa U/DR 7-6-00 F/B/O BPrnard A Lub
Shcer 1- A'ame as opymis on conveyunce dacumen[
5044 F. 750 S
Addrecs (NUm6er and Sveet)
Hall. Partenheimer & Kinkle
Company
Telephone Number
E-mall
Se11er7 - Name as aypeors on conveynnce document
Address (Number ond Stree[J
Ciry, Smte, and ZIP Code
Under penaltles of perjury, l hereby certify that this Sales Disclosure, ro the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance �vith tC 6-1.1-S.S, "Real Property Sales Disclosure Act".
SignoNreo/Seller // ij // �j�_ /�j/ � SignaNreojSeller
Klinton M. Obert
Buyer I- Name as oppears on mm•eyanre document
Address (Num ber and Svee[J
/
Buyer 2� Name as appeors am m�veyunre documen[
7418 S 550 E
Addresr (NUmber and StreetJ
Fort Branch IN 47648
THE SALFS DISCLOSURE FORM AIAV 6E USF.D TO APPLY FOR CERTAIY DEDUCf10ti5 FOR THIS PROPERTI'. IDENTIFI' ALL OF THOSE THAT APPL\'.
YFS NO COtiDIT10Y
� ❑ 1. 4'Jill [his property be [he buyer's primary
residence? ProvidecompleteaddressoFprimary
residence, including county:
5044 E 750 S.
Address (Number and SVee[)
FoR Branch. IN 47648 Gibson
Ciry. Smte ZIP Code County
❑ 0 2. Does the buyer have a homestead in Indiana to be
vacated For this residence? If yes, provide
complete address of residence being vacated,
including county:
Address(Numbero�treet�/�— �r�� ���% Do
d" "
C7ry, Sw[e ZIP Code Counry
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❑✓
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3. Homestead
4. Solar Energy Heatlng/Cooling System
5. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is this property a residential rental property?
❑ 0 9. Would you like to receive tax statemenu for [his
property via e-mail? (Provide contoct in�ormation
below. Please see instructians for more information.
Notavaila6le "n all counties.)
Klinton M. & -ri�Obe •
c.n.�,.... �.o�o�ro �w�er rn�rnrr nnma E-mall