Homestead_Martin (18) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER • ' . . - - • - .
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Title
P.O. Box 13, 219 N. Hart St. Hall, Partenheimer&Kinkle
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050
City,State and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) ..
_ _ - -
Cynthia A Grisham
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
2191 Warrenton Road
Address(Number and Street) Address(Number and Street)
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 requir d by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
1/4.0to, a _ anni
Signature of Seller ,/ Signature of Seller
cynthia A Grisham 631 8 /2016 _ I� la-_
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller T— ! ; '- r•� �DD/Yrvr)
//F.BUYERS)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITE i. TH-T 1 ' _ ) -- ' .-
Ora E. M rtin 2) Lori A. Martin
�B i+A37fib as appears on conveyance document Buyer l-Name as appears on conveyance docum R 1 1 2016
2581 W. Jill Drive 2581 W. Jill Drive
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 Prin - •n IN 4767E1410171.'
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YF��tl6—CO.
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3. Homestead
residence? Provide complete address of primary U Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑ co
2191 Warrenton Road 5.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ 7 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
IZ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.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.
2581 W. Jill Drive Not available in all counties.)
Address(Number and Street)
Princeton, IN 47670 Gibson Ora E.Martin&Lori A.Martin -23 -14- yDO-oo0 .oy/ y
City,State ZIP Code County
Primary property owner contact name E-mail