Homestead_Doty INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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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
TESEVAIERISI/GWANTOR(Shf.--Valf M-5-777CIA...11.--7,..sTh.--'713" .77.--7-F-1.7.7n1-1:-1-7-----774777,-77-;1-..-
Anthony W Hellums Sondra.11 Hellums
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1837 W Buffington Place 1837 W Burlington Place
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 c plet s requ' e y ly.v,and is prepared in accordance with IC 6-1.1-5.5,"Real Prope Sales Disclosure Act".
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S nature of Sc
Signature of Seller
Anthony W Hellums 06/29/2016 Sondra D Hellums 0609/2016
Printed Name of Seller Sian Date owm/owyrrn Printed Name of Seller Sian Date(MM/DO/nn)
lif;BUYER(SI/GliANTEE(SJC:TATPLICATIONIFORT.FrOPERrMTAXTEDUETIONS:1-4DENTIFY(AII.ITEMSITANTAPpLYfr-".• .7-- --v-2-77-1.
James H. Doty Lilibeth S. Doty
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document F It
611 N. Hart Street 611 N. Had Street .
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 THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION GIBSON COUNTY Atirnmop
VI [II 1.Will this property be the buyer's primary [ ] 111 3.Homestead
•
residence? Provide complete address of primary 9 121 4.Solar Energy Heating/Cooling System
residence,including county:
0 IN 5.Wind Power Device
611 N Hart Street
Address(Number and Street) 9 [7] 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson_.. 9 171 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 Fl 8.Is this property a residential rental property?
0 Z 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 9 RI 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)
James H.8,Lilibeth S.Doty a 6 -
City,State ZIP Code County
Primary property owner contact name E-mail