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HomeMy WebLinkAboutHomestead_Gatewood INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Roman Ricker Attorney Preparer of the Sales Disclosure Form Tide 219 N. Hart St.,P.O. Box 13 Hall, Partenheimer&Kinkle Address(Number and Street) Company Princeton, IN 47670 812-386-0050 rrickerr@hpk-law.com City,State,and ZIP Code Telephone Number E-mail 8:;SELCER(S)'/•GRANTOR(S);, r. ,. 77 ___-- __t•, .. .,�. �t3°,..._ ' .-- .77-_Lill 7 _ T -- Darnell I Kellomv Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 439 S Walnut St 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 anted complete as required y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller ;�� C� Signature of Seller flamell I a ? t. k.ck Inn s �TjA/ p /2016 Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sion Date pi/En F='BUYER(S)/GRANTEE(S)"=APLPCATIONt FO Rill ROPERTYrTAXXDED.UC TlON5f[DENTIFYALL'•ITEMS•THATFAPPLY `t-{' Fr Tara L.Gatewood i _ ika Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveya ,e disc : en j '' 102 E. Mulberry St. - Address(Number and Street) Address(Number and Street) SEP 1 3 2016 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION IA ❑ 1.Will this property be the buyer's primary [ ❑ 3. Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 439 S Walnut Street ❑ ig 5.Wind Power Device Address(Number and Street) ❑ M 6. Hydroelectric Power Device Oakland City, IN 47660 Gibson ❑ 0 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 ❑ 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) I ' 4 2 ht CII �r� Tara L.Gatewood O6.I 4-18- 3 D9 001. 05 4£YXJ7 City,State ZIP Code County Primary property owner contact name E-mail