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Homestead_Burns
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER - . - . Roman Ricker Attorney Preparer of the Sales Disclosure Form Title 219 N. Hart St.,PO Box 13 Hall, Partenheimer& Kinkle Address(Number and Street) Company Princeton, IN 47670 812-386-0050 City,State,and ZIP Code Telephone Number E-mail E.SELLERS)/GRANTOR(S) . • . . Kenneth R Buehner Janice L Buehner Seller 1-Name as appears on conveyance document Seller 2-Name os appears on conveyance document 6465 S 700E 6465 S 700 F Address(Number and Street) Address(Number and Street) Fort Branch IN 47648 Fort Branch IN 47648 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and o lete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". e ignature of Seller O7 /t k/ar)f(t. nature of Seller 7/,0 20/4p t Kenneth R Buehner 44;t--- 1: Z6- anice L Buehner •••• : , - a, I . Printed Name of Seller Sign Date(MM/OD/YYYY) Printed Name of Seller j •Da. ):o/YYY11 FJBUYER(S)/GRANTEE(S)•=APPLICATION FOR PROPERTY TAX DEDUCTIONS-'IDENTIFY ALL ITEM`"I H• ' • . . . .. ' `4 -' . if . B ms ) Misty M. Burns niUL 2 1 2016 Buyer I-Name as appears an conveyance document Buyer 2-Name as appears an conveyance docume 1024 Punier St. 1124 P..I.r . Address(Number and Street) Address(Number and Street) . _I THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDn7ON (7] ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead residence? Provide complete address of primary - ❑ © 4. Solar nergy Heating/Cooling System residence,including county: 6465 S 700E fl 5.Wind Power Device Address(Number and Street) ❑ El 6. Hydroelectric Power Device Fort Branch, IN 47648 Gibson ❑ Ej 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ El 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) Jeffery E. Burns of 4 -1 0-i 7 -coo -COO. S 53-O0/ City,State ZIP Code County Primary property owner contact name E-mail