HomeMy WebLinkAboutHomestead_Blankenberger INDIANA SALES DISCLOSURE FORM SDF ID: - Page 2
DrP.REPARER; .','_ • •--_, - kt-f�i< . __,s `,L,:: _ .i _L A — = - - '7 ' ---"s:- __ I
J. Robert Kinkle Attorney 1 NI
Preparer of the Sales Disclosure Form Tide
219 N. Hart St. Hall,Partenheimer&Kinkle _
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050 irkihkle(athpk-law.com
City,State,and ZIP Code Telephone Number E-mail
1 r- _
Et,SEL[;ER(S)/GRANTOR(S)? 1. _ _ s°.: -
Keith A Block Y , � - � - - - _- - - _ I .. _ __
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
I
4187E 550 F
Address(Number and Street) Address(Number and Street) '
Princeton IN 47670
Telephone Number 1 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 co plete s Sequred,by}pw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
•
f P` l l/1 I
•Sig,ature of Se ler C Signature of Seller 1
Keith A Block )b2 Ai3
Printed Name ofSeller Sian Date 0 HM/DD/YYYl1 Printed Name of Seller 1 Sian Date lMH/DD/YYYYI
F:.B - • S)/GRA`: )``APP,I.IGATION FOR?P.ROPERTYTAXDF(,8_U < ,IONS IDEN,I L,ITEMSrTH TIAFPI : .; 1
K le R. RI.nk-n.-r.- \R Fidget L. Blankenberger I
• .ears on conveyance document er2-Nome as appears on co . ce document
6304 S. 600 W. 6304 S. 600 W. I
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 Owensville. IN 47665
D
THE SALES DISCLOSURE FORM MAY BE.USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APP 7
YES NO CONDITION r FS NO CONDITIO, ■ j
Z ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead , 1�
residence? Provide complete address of primary ❑ ® 4.Solar Energy Heating/Coolir ,rsern 2013
residence,including county:
4( 87 S ❑ Q I
5.Wind Power Device
55ot T 1 • ,
Address(Number and Street) ❑ IJ 6. Hydroelectric Power Devic- ': , —0.111.
F'PRW e.E To N, IA' 4 7 6 7 D a t t3 S o N ❑ ❑ 7,Geothermal Energy H •=r/ gt�tb i DIT�R
City,State ZIP de County 1
❑ LK 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 for more information.
Not available in all counties.)
Address(Number and Street) I
al0 - la -36 - 400-0° 1 - 1 6 q-DO Li
City,State ZIP Code County
Primary property owner contact name I E-mail