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Homestead_Baesel INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.:PREPARER_ _' . -1 - ' s . ^_-` _ 6_ Roman Ricker Attorney Preparer of the Sales Disclosure Form Tide P.O. Box 13, 219 N. Had St. Hall,Partenheimer& Kinkle Address(Number and Street) Company Princeton, IN 47670 812-386-0050 City,State,and ZIP Code Telephone Number Email E..SFEIER(S)%GRANTOR(S) _ _ _. _ )_-__v .a _ _. : .- The Ralph E Koch Revocable Living Trust u/a October 3 2000 Ralph E Koch Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 37906 Baxter Rd 37906 Baxter Rd 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 an r complete Pas re uired bylaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". G ���„ 7 Signs/re of Seller Signs re of eller Ralph E Koch as Trustee 07/ /2 /2016 Ralph E Koch individually 07/ /2 /2016 Printed Name of Seller Sian Date IHM/DD/Ym') Punted Name of Seller Sian Date(NM/DD/M71 BUNER(s)'/-GRANTEE(S).1ARP,,L[CATION IF_OaPROPERTYTAVDEDUGTIONS-.'IDENTIFY_ALE.ITEMS'.THAT-APPaiY!_' _- _- _ Lisa A. conveyance document Buyer 2-Name as appears on conveyance docume 4016 S. 600 W. Address(Number and Street) Address(Number and Street) Owensville, IN 47665 THE DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS YOPER NO CONDITIp,OFTHOSETH�agB OQODITQR ❑ 1.Will this property be the buyer's primary E ❑ 3. Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ ❑ S.Wind Power Device 10119 S Koch Drive Address(Number and Street) ❑ 0 6. Hydroelectric Power Device Poseyville, IN 47633 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ig ❑ Z 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 ❑ IA 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. City,State ZIP Code County Primary property owner contact name ' E-mail