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INDIANA SA2ES DISCLOSURE FORM SOP ID: Paee 2
`D.-TREPARER,
J. Robert Kinkle Attorney
Sofa Disclosure Form Title
IPreparerofthe
19N. Hart Street Hall, Partenheimer & Kinkle
Address(NumberandStreet) Company
Princeton, Indiana 47670
City, State. and ZIP Code Telephone Number E-mail
,E.-SELLER(S) .GRANTORS )c� Tr��V
Allison Hockgeiger Miller 2Wa Allison Hockoeiger
Seller I - Name as appears on convemme document
PO Box 7?
Seller 2 - Name as appears on conveyance document
Address (Number and Street)
Mt Carmel IL 62863
Address (Number and Street)
City, State, and NP Code
CkK Stute. and 27P Code
E -mail
Tdephone 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
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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SignatureofSellm' 6/ SignatureofSeller
Allison Hockgieger Miller 12127/2010
Printed Name aSeller Sign DOW (MMIDDIffM Printed Name ofSdlff Sign Dow (MWDDIYYM
.F; BUYERQYGRANTEE(S).r APPLICATION FOR1PROPERTY ,TAXDEDIJCTIONS-. IDENTIFY-ALL' ITEMS-THAT APPLY,' .-j
William J. McCandless
Kelly R. McCandless
Buyer 1 v Name as appears on conveyance document
Buyer 2 - Name as appears on conveyance document
643 W. Division Street
643 W. Division Street
Address (Number and Street)
Address (Number and Street)
47660
Wallan,d
Oakland City, IN 47660
_uy, to �WN
City, State, a no ZIP Code
E-mail
I 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 YES NO CONDITION
FVJ ❑ 1. Will this property be the buyer's primary
[Z] E] 3. Homestead
residence? Provide complete address of primary
4. Solar Energy Heating/Cooling System
resident including county:
V/
S. Wind Power Device
:?I!�. /Z/1 f z/. <, 104�1
❑ 0 6. Hydroelectric Power Device
Address (Number and Street) '
a4Kf4!!!LO K"ZL!r 4,!:� iq Z�; -7 C9
❑ ❑[Z] 7. Geothermal Energy Heating/Cooling Device
❑ property a residential rental property?
CIO;, SwtepZfP Code County
2. Does the buyer have a homestead in Indiana to be
H
vacated for this residence? If yes, provide
you like to receive tax statements for this
complete address of residence being vacated,
erty via e-mail? (Provide contact information
including county:
below. Please see instructions far more information.
ell
l
Not available in all counties.)
/-/-/? & o f/, 6 a 3
Address (Number and Street)
Q y SW te V P 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 not necessary if no Homestead Deduction is
being filed.)
"g a a to re of B oyer '1V SomatureofBuyeWSpouse
offiam J. McCandlp�q 19/?712010 Kp4ly R McCandless 121271010
Printed Legal Name of Buyer I Slqn DOW (MMIDDIM7n Printed Legal Name ofBayer 21S�Pouse Sign Date (MMIDDIYYYYI
:
Number ast S�digidarsuyer 2 /Spouse Driver's State Last 5 Digits ofSocial Security
LicenselID10th er Number Number LicemellDlOtherNumber
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