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INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1803031 Paget D.PREPARER _ - -,) • Samantha Cutsinger Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 samantha.bti©mw.twcbc.com City,State,and ZIP Code Telephone Number E-mail E.SELLER(S)JGRANTORIS) Charles H Cone Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 8317 S SR 61 Address(Number and Street) Address(Number and Street) Oakland City,IN 47660- 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 re' ' .ed-by la% ,and prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". /`! .e liesamw_...—.. ■La- -_-..a-Signn ure 19.44/471 AA"a eller & Signature of Seller Pn-wlN-me rr41 fee- ci--nr,•,vv•„"/u yi P-,.....4"^n•rr(c-i',- r' p ,gt,,. Myy\n . F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEM HA� P IH1l` ("Jor"Jordan S Mays Katherine M Mays . dan t-.ome as appears on conveyance document Buyer 2-Name as appears on conveyance documeDEC 29 2014 421 Dalewood 421 Dalewood Dr. Address(Number and Street) Address(Number and Street) Vincennes,IN 47591- Vincennes,IN 47591- 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 ”. •40 fi © ❑ I.Will this property be the buyer's primary © ❑ 3. Homestead residence? Provide complete address of primary u .Solar Energy Heating/Cooling System residence,including county: ill S.CROSS ST. ❑ © 5.Wind Power Device Address(,Number and Street) ❑ © 6. Hydroelectric Power Device Francisco,IN 47649 GIBBON ❑ © 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ © 6. Is this property a residential rental grope ty? 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) ei4 — i..i .d0 -/0/-a o0.®23 -OOS- City,State ZIP Code County Primary property owner contact name E-mail 1r `\I Vg!' 'W/