Homestead_Scott INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER . '
Roman Ricker Attorney
Preparer of the Sales Disclosure Forts Title
219 N. Hart St.,P.O. Box 13 Hall, Partenheimer 8 Kinkle
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050 rrickerehok-law.com
City,State.and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) . • - - -.
Aaron Fnterprises Inc
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
5101 Klpitz Road
Address(Number and Street) Address(Number and Street)
Under penalties of perjury, t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and cco�m let gmred by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
is{gn5 atureofS lley//Vp Signature of Seller
K T`ti v.p.TL ., K l utA President O l 12 /2016
Printed Name ofSeller
Sign Date(MM/DD/YYYY) Printed Name of Seller -ir'1 Sgtr Bp[e(MM/OO/YYY17
F.BUYERS)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL I S H T A ryl/r(yI
homes Wayne Scott Patricia R, Scott
Etuyr 1 Arne as appears on conveyance document
Buyer 2-Name as appears on conveyance dgoynppt1 A 2016
5404 S. 800 W 5404 S. 800 W. JCC�r Y
Address(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary < � ID 3. Homestead
residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System
residence,including county:
511 S 9th Avenue ❑ fl S.Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ Ei 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
Q ❑ 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.
5404 S. 800 W. Not available in all counties.) p
Address(Number and Street) 014_ 2_3 - o(o - ratio _00a, g .O _oo 9
Owensville, IN 47665 Gibson Charles Wayne 8 Patricia R.Scott U
City,State ZIP Code County
Primary property owner contact name E-mail