Homestead_Perry (18) INDIANA SALES DISCLOSURE FORM SDF ID: ■ Page 2
D.PREPARER • 1
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Title •
PO Box 13,219 N.Hart St. Hall, Partenheimer&Kinkle
Address(Number and Street) Company
Princeton, IN 47670
E-mail
I
•E.SELLERS)/GRANTOR(S) . ' - " - - - -
The Estate of Betty I Reed Fred Dike Unsunervised Pers RPD
Seller I-Name as appears on conveyance document Seller Z-Name as appears on conveyance document •
5168 S 970 W
Address(Number and Street) Address(Number and Street)
Owensville IN 47665
City,State,and ZIP Code City,State,and ZIP Code
Telephone Number E-mail Telephone Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property}Sales Disclosure Act".
Signature of Signature of Seller
Fred Dike Unsupervised Pers Reo 01/ 6 /2016 -
Printed Name of Seller Sign Date(MM/oo/YYYY) Printed Name of Seller Sign Date(MM/aa/rvny
F.BUYEJS1/GRANTEE(S)-APPLICATION FOR PROPERTY-TAX DEDUCTIONS=IDENTIFY ALL ITEM$IMAg APFjbN6 .i - -
( Billy W. Perry Shon A. Name J LL
son conveyance document Buyer Z.Nameas appears on conveyance dgqumen�-
6627 N.SR 65 6627 N SR 65 Y/.f�dl/0
Address(Number and Street) Address(Number and Street) GIBSON COUNTY AUDITOR
UDITOR
Hazleton, IN 47640 Hazleton, IN 47640
Ci` State,and ZIP Code City,State,and ZIP Code i
• E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDU CTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
z ❑ 1.Will this property be the buyer's primary CI ❑ 3.Homestea•
residence? Provide complete address of primary • PA d. oar nergy eating/Cooling System
residence,including county:
❑ 0 5.Wind Power Device
720 W Makemson Ave
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 ❑ 2.Does the buyer have a homestead in Indiana to be ❑ B•Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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.
6627 N. SR 65 Not available in all counties.)
Address(Number and Street)
Hazleton, IN 47640 Gibson Billy W.&Shon A.Perry 022' ' //-13 -A Ocf-OO A . A 98 -G z 8
City,State ZIP Code County
Primary property owner contact name E-mail