Homestead_Kissel (12) INDIANA SALES DISCLOSURE FORM SIN ID: Page 2
;CI:LPREPAREK_
Ray M. Drulev Attorney No.4759-26
Preparer of the Sala Disclosure Form Title
505 N.Church Street,PO Box 146 Law Office of Ray M.Drulev
Address(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 drulevlawa)yahoo.com
City,State,and ZIP Code Telephone Number E-mail
.E..SEL'LER(S)/GRANTOR(S)—� - - --- -- -- ---- --- �_c- .' _ . :.:_-' - - --'--°-- ----- -- -- - - --. _ -.
J Frank Chandler Janice I Chandler
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1299 W SR 68 1299 W SR 68
Address(Number and Street) Address(Number and Street)
Hanhstadt IN 47639 Haubstadt IN 47639
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".
tg ture of Seller �G( - Si` Lure of Seller
,I Frank Chandler Oct 7 ?9-�4 Janice L Chandler Oct 7 7014
Printed Name ofShcer Sian Date(MM/00/YYYY) Printed Name ofSeller Sian Date(MM/DD/YYYY)
I A •'F..BUYER(S)/.GRANTEE(S)- APPLI CATION,FOR'PROPERTYTAXDEDUGTIONSt:IDENTIFY_ALL IT - YAPPV_ - ' .
Kenneth A.Kissel Elizabeth C.Kissel _—i 6 /
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1223WSR64 1223WSR64 NTT 8 2Q14
Address(Number and Street) Address(Number and Street)
Haubstadt. IN 47639 Haubstadt.IN 47639 n.
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YCONDITION
0 e 1.Will this property be the buyer's primary 3. Homestead
residence? Provide complete address of primary ❑ N 4.Solar Energy Heating/Cooling System
• 19 residence,including county:
El 51 5.Wind Power Device
1SR68
Address(Number and Street) ❑ 12 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El 2.Does the buyer have a homestead in Indiana to be El 0 8.1s this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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) al_ aa-,t-3 c -cob-IQ?o a
City,State ZIP Code County ICJ
Primary property owner canted name E-mail