Homestead_Bobbitt INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Daniel A. Moon Attorney
Preparer of the Sales Disclosure Form Tide
116 S. Main St. Reeves,Cochren&Moon
Address(Number and Street) Company
Princeton, IN 47670 812-385-1843 danielmoonlaw @gmail.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(5)/GRANTOR(S) - - •
Clinton R.Simmons Clay D. Enyeart
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
5224 Black Jack Circle 504 E. Broadway
Address(Number and Street) Address(Number and Street)
Punta Gorda, FL 33982 Princeton, IN 47670
Under nalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and e as r Ijd.b_y4uw,and is prepared in accordance wit 6-1.1- ,"Real Property Sales Disclosure Act".
� o - ,, ,
Signature of Seller Sigr re of Seller
Clinton R.Simmons 07/29/2016 y D. Enyeart 7/29/2016
Panted Name of Seller Sign Date(MM/oDM111 Printed Name ofSeller Sian Date(NM/oa/nTY)
F.BUYER(S)/GRANTEE(S)-=APPLICATION FOR PROPERTY_TAX DEDUCTIONS= IDENTIFY-ALL ITEMS THAT APPLY . _. TT _
Roy D. Bobbin
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears an conveyance document
i
9 23 u . ckt. t-y Si- .
Ad ress.ii(..Number and Street) 1I I �I Address(Number and Street)
\1St toaZI
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TIC/1198? ��
YES NO CONDITION I YES NO CONDITION �'r Cr) !1
L "
12 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead Ty.
residence? Provide complete address of primary El 4.Solar Energy Heating/Cooling System t/T
residence,including county: C•4'
❑ j9 S.Wind Power Device
Address(Number and Street) ❑ IN 6.Hydroelectric Power Device
City,State ZIP Code County ❑ 12 7.Geothermal Energy Heating/Cooling Device
[I ❑ 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 ❑ E2 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.
1230/1231 McKinley Not available in all counties.)
Address(Number and Street)
Princeton, IN 47670 Gibson 4-Q,421`303-Oo o.5 .2-0.20
City,State ZIP Code County