Homestead_GrossINDIANA SALES DISCLOSURE FORM
D.PREPARER- � � � �
J. Robert Kinkle
Preparer o((he Sala D'udos�re Form
Addr� (A'um6er and Sveet)
Princeton. IN 47670
Ciry. Smu, and ZIP Code
E. SELLER(Sl/GRANTOR(Sl •
�QE Prooerties LLC
Seller 1- Nome as appears om m�vryvnce docummt
Addres (Num ber and Sveet)
Franr.isr.o. IN 47Fi49
Title
iall, Partenheimer & Kii
Lompony
Sel/er d- Name as appmrs on
Addrett(NUmberandSheeQ
Ciry, Smtq and ZIP Code
E-mail
Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
a� comp�q��aw, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Proper[y Sales Disdosi re Act".
!-
Signaa o(Selfer � � Signamreo(Seller �
Addrcss (NUm6<r and Sveet)
IDENTIFY ALL
os appears on ronveyance
Addrrss (Num6er and Streel)
Patoka.IN 47666 Patoka IN 47666 �"'°"""
Ciry,Smre,andZlP(adr Ciry,Sw[4andZlPlade �S�II
�
THE SALFS DISCLOSIIRE FORM MAY BE USEO TO APPLY FOR CERTAIN UEDURIONS FOR THIS PROPERTV. IOENTIFY ALL OF THOSE THAT APPLY.
YFS AO COYOITION
Q ❑ 1. Will this property be the buyer's primary �
residence? Provide complete address of primary
residence, including county:
200 S Main St
Addrrs (Number andStree[J
Patoka IN 47666 Gibson
Ciry, Smte Z/PCodt Caunry
0 ❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county: p
2242 W 400 N Ou�Q9p�y.
Addrm'(NumberandSVertJ �
[iry, Smte ZIP
u
❑ ❑�
❑ �
❑ �
❑ o
❑ ❑
3. Homes[ead
S. Wind Power Device
6. HydroelecMc Power Device
7. Geothermal Energy Heatlng/Coo
8. [s this property a residentlal ren
9. Would you like to receive tax sta
property via e-mail? (Provide con
available in all
. Dy -�s-lo�-000
�m ���
P\�:
g Device
property?
nents for [his
�t information
re in�ormation.
,y-ol�.
Under penalties of perjury, 1 hereby certify [hat this Sales Disdosure, [o � - , rect
and complete as required by law, and is prepared in atcordance wi[h IC 6d.1-5.5, "Real Property Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/O[her numbers are not necessary if no Homes[ead Deduction is
being filed.) I
x C��a-�.� �- ...�., _ � I � � �A �- � -
�Signamr JBvyerl � SlgnoNreo(Buyer2/5 use �
Pnnted Legal Name of Buyer 1 Sign Dalt (H.4/00/YYYf7
_�,�
License/!D/O[her Num6er
Ka[ �(�rocc �
Pnn[edLegalNomeo(Buyer2/Spouse SljnDate(MM/00/YYY17
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Number License/ID/OtherNumber �