HomeMy WebLinkAboutHomestead_Mayberry INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
LD?PRRP,ARER - -∎ z s 7,W 1 ,45..; , t `t'l` r ._ -, =`f - y-.'::.,. v<. . 3, r. r _
Roman Ricker Attorney
Preparer of the Sales Disclosure Form Title
219 N. Hart St., P.O. Box 13 Hall, Partenheimer 8, Kinkle
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050
Ciry,State,and ZIP Code Telephone Number E-mail
.t:SEL'!ER(S)/.GRAN:T°R(Si `r.• ."3,- ...:-.7.,-a--zr `L.-:3( _a _s .F . ' 5...�7:17 m-.
Richard A Davis Jr
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
308 N Main Street
Address(Number and Street) Address(Number and Street)
Owensville IN 47665
Under penalti s of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an co pie s re ed by law, nd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
l�aK/ A/-/y /(o
Signature of Seller Signature of Seller
Richard A Davis Jr
Printed Name of Seller Sian Date(MM/DD/YYYt) Printed Name of Seller Sian Date(M.M/DDO'm]
_F.L BUYER(S)(GRA'N3TEE(S)k-APP..LIGATION;F,O B�EROP,ERT,YaMkDEDUCTIONS=•IDENTI W T MS-Ti Y; - �_ _„
Phyllis G Mayberry
Buyer I Name as appears on conveyance document Buyer 2 Name as appea co
2900 Hickory Street }�
. _Address(Number and Street) ' Address(Number and Street) APR 1.5 1016
Clinton, OH 44216
THE SALES DISCLOSURE FORM MAY HE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ lg
308 N Main Street 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Owensville, IN 47665 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 ED 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.
Not available in all counties.)
Address(Number and Street)
Phyllis G.Mayberry(.51(9- I ']-M-ti o4 -bc-'Ii.l tax
City,State ZIP Code County
Primary property owner contact name E-mail