Homestead_Hoke INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:PREPARER'_ - -
Ray M. Druley Attorney No.4759-26
Preparer of the Sales 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 druleylaw(dvahoo.com
City,State,and TIP Code Telephone Number
E-mail
!E:-SELLER(S)/GRANTOR(S)-_- 1 - - ;
Randy M Kiesel Cynthia K Kiesel
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1652 W 950 S 1652 W 950 S
Address(Number and Street) Address(Number and Street)
Under/p nalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an•• ple eas require+ +' law, is prepared in accordance with'l(6-1.1-.. =.•e. P : I erty ales Disclosure Act".
Signature of Selle UT eof5e ler 1
c.++ u - May 22 2015 Cynthia K Kiesel ✓ May 22 2015
Printed Name of Seller Sian Date(MM/aa/YYYI) Printed Name of Seller Sign Date(•M/DD/YYYY)
:F.BUYER(S)/GRANTEE(S)'--APPLICATION:FOR PROPERTY.TAX-DEDUETIONS,-IDENTIFY ALLITEMS.THATAPPLY, 17-__. ____o --, ._
Brent A. Hoke Kara R. Hoke
Buyer 1-,Name as appears on conveyance document Buyer 2-Nome as appears on conveyance document
800 E.Walnut 800 E.Walnut
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648
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
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑ Q S.Wind Power Device
1868 W 950 S
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
Q ❑ 2.Does the buyer have a homestead in Indiana to be ❑ Q 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Q 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.
800 E.Walnut Street Not available in all counties.)
Address(Number and Street)
Fort Branch, IN 47648 Gibson di— /d?c44_ oa - Goa. ,399-oar
City,State ZIP Code County
Primary property owner contact name E-mail