Homestead_Dodson INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER _ - •
Roman Ricker Attorney
Preparer of the Sales Disclosure Farm 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)
Habitat for Humanity of Gibson County Inc
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1302 W Brumfield
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
andd/c�/Qpmplett,.eee as r ire Q bylaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
l/Iisnot e Seller 1 Signature of Seller
,laster9fvmhPm— g 06/01/2016 / r mm)
Printed Name of Seller Sign Printed Name o Seller D e H. DD
F.BUYER S GRANTEE(S)L APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITE T T :J_t
Amber R. Dodson I4N .1 L016
- ame as appears an conveyance document Buyv2-Name as appears on conveyance doss m�
574 W.Glendale Street
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 _ WIml1•e
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION ES NO CONDITIO•
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of primary C , • • - -rgy eating/Cooling System
residence,including county:
103E Sinclair Street El 12 S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Fort Branch. IN 47648 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 ❑ 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) /
Amber R.Dodson a 6 -19-13- 410A-000. 78 Se OM
City,State ZIP Code County
Primary property owner contact name E-mail