Homestead_Lloyd INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER " . : .: ":
J. Robert Kinkle Attorney _
Preparer of the Saks Disclosure Form Tide
219 N Hart St. Hall. Partenheimer&Kinkle
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050 jrkinkle @hpk-law.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S). ..
Stephan Harker
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
3327 E Sierrita Rd
Address(Number and Street) Address(Number and Street)
San Tan Valley AZ 85143
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 requi es r y law,and is prepared in ac ordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature ofs-,ler I /1 / Signature of.Seller
/(77JJ
,Stenhan Hecker i
Printed Name of Seller Sian Date IMH/DWYY 1'1 Printed Name af Seller Sian Dare 0•4/DO/YYY11
'F.BUYER(S)/GRANTEE(S) APPLICATION FOR PROPERTY TAX DEDUCTIONS=IDENTIFY'ALL.ITEMS THAT AP' , ;' : . -
Paul Lloyd Kath LI. • ;
Buyer l-,Name as appears on conveyance document Buyer 2-Name as appears on conveya ■ docu' . VII 'MI Mr
911 Blackfoot Drive 911 Blackfoot Drive
Address(Number and Street) Address(Number and Street) AUG 2 0 2015
Ft. Branch. IN 47648 FL Branch, IN 47648
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF TIMSMIAT
YES NO CONDITION I 'ES NO CO, I ITION
0 ❑ 1.Will this property be the buyer's primary I 0 ❑ 3. Homestead
residence? Provide complete address of prima LJ IA 4.Solar Energy I eating/Cooling System
residence,including county: ❑
5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 El 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.
911 Blackfoot Drive Not available in all counties.)
Address(Number and Street) d/_ /g �/ -a00- 3(/X _O a-V
Ft.Branch. IN 47648 Gibson 10-- t„Jtp V -�..�tU
City.State ZIP Code County
Primary property owner contact name E-mail