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Homestead_Riley
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D>>.P,REP:ARER r-i: - .. .. _._ , - F-77, .... - , n Roman Ricker Attorney Preparer of the Sales Disclosure Form Title 219 N. Hart St., P.O. Box 13 Hall. Partenheimer&Kinkle Address(Number and Street) Company _Princeton, IN 47670 - 812-386-0050 Ciry,State,and ZIP Code Telephone Number E-mail '£ SEfiEER(S)Y/GRANTOR(S);:7477z37. s'..,.Y° ;. - - TT Marsha F Henrich f/k/a Marsha F Fvans Ricky A Henrich Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 308 W Brummit Street 308 W Animmit Street Address(Number and Street) Address(Number and Street) Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowle and belief,is true,correct and complete as required by law,and is prepared in accordance with 1.1-5.5," al Prop Sales Disclosure Act". `{"Ifk cuod 47 Syr Signature of Seller Sign a of Seller Marsha F Henrich f/k/a Marsha F Evans 06/ aS /7016 Ricky A Henrich 06/ /2016 Printed Name of Seller Sign Date(MM/DD/1YYY) Printed Name of Seller Sian Date(M.N/DD/YYYY) E:BU.YER'(S)/GRANTI.EE(S)S.AP,P LIGATION;FORT RR OPERTY{TAX'DED.UCTIONS- IDENTIFY±ATLL'ITEMS THAAT'`AP.P :, .'- Buyer]�Name as appears on conveyance document Buyer 2-Name as appears on conve) �me 903 E.Water Street ��g��g Address(Number and Street) Address(Number and Street) • THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF'�N09E+IY1At'iPPLV. YES NO CONDITION YES NO CONDITION [�J 1.Will this property be the buyer's primary Q ❑ 3. Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ f 5.Wind Power Device 306 W Brummitt Street Address(Number and Street) ❑ 0 6. Hydroelectric Power Device Owensville, IN 47665 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County Q ❑ 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. 903 E.Water Street Not available in all counties.) Address(Number and Street) �1 ''I Princeton, IN 47670 Gibson Chandra R.Riley o<•1P -17-le) -eA ti I-bbeb,n(n o1' ): - City,State ZIP Code County Primary property owner contact name E-mail