Homestead_Merry INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D::P.REPARERIi -a Y 77 "z --I ° .—__77--,,
yRoman Ricker Attorney
Preparer of the Sales Disclosure Form Title
P.O. Box 13, 219 N. Hart St. HaJL_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'` ; .- _ _ .
The Marion B Koherstein Primary Trust
Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
1006 Wilson AVP
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required b law,ant is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
�1. . .�, / a
S nature of Seller Signature of Seller
Marion B Koberstein Trustee 8 an/G /9016
Printed Name of Seller Sign Date(MM/on/YYYY) Printed Name of Seller lS .—.
thin Date(14M/DD/MT)Y)
Fi BUYERS7/GR ANTEE_S -_A__PLICATION FORFROERTY.,A7ED_UCTIO_NS=1DENTIFY'ld rjTEMSTH ' P � 7- , _L
=J
John Merry Randie Merry f
Buyer I-Name as appears on conveyance document Buyer I-Name as appears on conveyance document
3803 E.50 N. AUG 2 2 2016
Address(Number and Street) Address(Number and Street) �d�
Princeton, IN 47670 +-4-0
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P't• •. t r it AtttlFTHOSETtiA A4PtY.
YES NO CONDITION YES NO CONDITION \/\J
0 ❑ 1.Will this property be the buyer's primary IZ ❑ 3.Homestead
residence? Provide complete address of primary 11 c� • • , - - 3 f1ating/Cooling System
residence,including county:
3991E 50 N ❑ f4 5.Wind Power Device
Address(Number and Street) ❑ RI 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 171 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
gi ❑ 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 ❑ 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.
3803 E. 50 N. Not available in all counties.)
Address(Number and Street) �
Princeton, IN 47670 Gibson John Merry � 'a I I -I ce _b N• , 587-cal
City,State ZIP Code County
Primary property owner contact name E-mail