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Homestead_Cooper (2) • INDIANA SALES DISCLOSURE FORM WE ID: PaaL .D.PREPARER - • J. Robert Kinkle Attorney Preparer of the Sales Disclasure Form Title 219 N Hart St. Hall. PArtenheimer&Kinkle Address(Number and Street) Company Princeton,IN 47670 812-386-0050 jrkinklec hpk-law.com City,State,and ZIP Code Telephone Number E-mail £.SELLER(S)/GRANTOR(S) - :- - Dale C) Hyatt - - -. .. Seller l-Name as appears on conveyance document - Seller 2-Name as appears on conveyance document PO Bnx 343 Address(Number and Street) Address(Number and Street) Patoka IN 47666 _ 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". Signhture of Seller /aoa` Signature of Seller Pale O Hyatt Nellie I.Hyatt Printed Name of Seller Sian Date(MM/DD/YYYI) Printed Name of Seller Sign Dare(MM/Da/MT) F.-,BUYER(S)/GRANT EE(S)=APPLICATION FORPROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY`:` - . .- Herman J.Cooper Buyer I-Name as appears on conveyance document Buyer 2-Name as or o1on nceetttt.-. 625 N.West St. ,e/p Address(Number and Street) Address(Number and Street) Princeton, IN 47670 _ THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES KO CONDITION 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ -© 4.Solar Energy Heating/Cooling System residence,including county: 708 S Wood St ❑ 0 5.Wind Power Device Address(Number and Street) ❑ Q 6. Hydroelectric Power Device Patoka, IN 47666 Gibson ❑ Z 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County g/ g III Q 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) Gibson °26-6C4- a64oh OOO-/Q_Od 0 City,State ZIP Code County Primary property owner contact name