Homestead_Hogge INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
:1p;RREPARER1 _ =771,':17,=77 $,T7 `17 t:it ° 1. �- s ; ° __;-
Brian K.Mahoney Attorney
Preparer of the Soles Disclosure Form Title
822 Main Street,P.O. Box 176 Mahoney Law Office
Address(Number and Street) Company
Petersburg,IN 47567 812 354 8121 mahoneylawto7nwcable.net
City,State,and ZIP Code Telephone Number
E-mail
EISEIRSER(817, ANTOR(S)} -. � -: -7--7-72--1:, _ -- ., ; -
Darnell I Kellams
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
4231 W 300 N
Address(Number and Street) Address(Number and Street)
Petersburg IN 47567
�
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
rid\complete as requ red by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Parnell I Kellams 5—V-'\ tO
Printed Name of Seller Sian Date[MM/DD/M11 Printed Name of Seller Stan Dote FMM/DD/Y1WI
F.:BUYER(S)/GIUINTEE(S)'fAPP.LICATION;FOR'PROPERT\%TAXtDEDUGTIONS4IDENTIFY?ALL I T E M S:T H A T r A P,P L'r _-Tf 4',
Christina Rogge
Buye rl-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document f
9171WSR165 / t'
Address(Number and Street) Address(Number and Street) -
1,,/
YES NO CONDITION YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead I T i •� O•
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System •
residence, including county: n 0 S.Wind Power Devic,}UL 19 2016
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Gibson g
City,State LP Code 7.Geothermal Enerpi eat' , -
❑ NI 8.IS this pro �tfc .• .,a
❑ 2.Does the buyer have a homestead in Indiana to be �i [SO�I� •(] + `�,�ointi�-''
vacated for this residence? If yes,provide n 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) OX- / ,//(C�j/f j0 /coo.73‘_ 002
City,State ZIP Code County
Primary