Homestead_Ross (6)SALES DISCLOSURE FORM
Roman Ricker
Preparero(rhe Sala Dudosure form
Addres (Num6er and 5•see[)
Princeton. IN 47670
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E. SELLER(Sl/GfL1NTORfS1 .:
.�nh Collinc
Seller 1- h'ame as appears on ronveyonae dorummt
Addres (A'um6er and SveeQ
Owensville. IN 47665
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Title
iall Partenheimer & Kinkle
Narv Collins
Shcer 2- Name os appmrs on tonveyance dorummt
2995 S fi7.ri W
Address (Num6er and SveetJ
Jwensville. IN 47665
Ciry, S[are and7lPCode
/� / _�
Under penal[ies of perjury, I hereby certify tha[ [his Sales Disclosure, [o the bes[ of my knowledge and belief, is
a omplete asj equired by law, nd is prepared in accordance wi[h IC 6-1.1-S.S, "Real Property Sales Disclosi
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n
ignayreo elfer Signotureo elfer
Josenh Collins /� - '� � � s Marv Collins % �'�
Bv}�er I� A'ame as apyears on ronve}nnce dxumen[
Buyer 2- Nome as appears on
501 W. Warrick
Addrex(NUmherandSVeeQ Address(Num6erand5t
Owensville. IN 47665
THE SALFS DISCLOSIIRE FORM MAV BE USED TO APPLV FOR CERTAIN DEDUCTIONS FOR Tf715 PROPERTV. IDENTIFY ALL OF Tf10SE
0 ❑ 1. Will [his property be [he buyer's primary
residence? Provide comple[e address o( primary
residence, including county:
10A Kneioo Rd
Add�es(Num6erandStreetJ
Owensvilie. IN 47665 Gibson
Ciry.Sm:e ZIPCade Counry
❑ Q 2. Does [he buyer have a homes[ead in Indiana [o be
vaca[ed for [his residence? If yes, provide
complete address of residence being vacated,
including county:
Address (,YUmEer and SveetJ
Ciry; Srate Z/PCode Counry•
IJ.
E-moil
ie, wrrect
Ac[".
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� ❑ 3. Homestead
❑ 0 4. Solar Energy Heating/Cooling Syst �
❑ ❑Q S. Wind Power Device
❑ � 6. Hydroelec[ric Power Device
❑ � 7. Geothermal Energy Heating/Coolm, Device
❑ ❑✓ 8. Is [his property a residenrial rental property?
❑ ❑ 9. Would you like to receive tax statements for this
property via e-mail? (Provide conmct informotion
belaw. P/ease see instrucdons for mo�e information.
Not available in all counties.J
Z
E moil
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is�true, correc[
and comple[e as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure AcY'. (Note:
Spouse informa[ion, Social Security and Driver's License/Other numbers are no[ necessary if no Homes[ead Deduction is
being filed.) (
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Signamre of Bvyerl Signature of Ruyer2/Spouse I
Achloo R Rncc I�—� - I�
Lirense/lD/Other Num6er
Pnn[ed Legol Name ofB�yer 2/Spous<
LastSdigi[sofBuyer2/Spouse0riveri Smte Las[SDigiti'of5otial5ecurity
Number Litense/lD/O[herNumber I
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