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Homestead_Riley
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 J.Robert Kinkle Attorney Preparer of the Sales Disclosure Form Title 219 N Hart Street Partenheimer, Kinkle& Ricker Address(Number and Street) Company Princeton, IN 47670 812-386-0050 irkinkleehpk-law.com City,State,and ZIP Code Telephone Number E-mail 7EsSELL•ER(S)'/,GRANTOR(S) ' _ _ - _ _ . _� ___ -.� _ _. — � _ _�- __ �- .� Estate of Dennis R Wilkerson Seller]-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 200 E Walnut St Address(Number and Street) Address(Number and Street) Under penalties of perjury,l hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and tom lete1 uir d b law-and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". / 7 r Signature of Signature of Seller William Grubb Unsupervised Personal Reo 1 b ZS//7016 Printed Name of Seller Sian Da!!!le(MH/UD/YYYY) Printed Name of Seller Sian Date(M.M/DO/YrY) ;Ft,BUYER(S)/GRANTEE(ST±AP,8LICATION,FORBROPERTYiTAX(DEDUCTIONS IDENTIFY'ALL � T _ _, Kendra Riley ? 11• �___• Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 200 E.Walnut St. NOV 4. 2016 Address(Number and Street) Address(Number and Street) Fort Branch, IN 47648 THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 200E Walnut St ❑ Fl 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Fort Branch, IN 47648 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 El re 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) a-1 z-- 1 - 90 Li- r�/'N,rn tj g 1,_ Da City State ZIP Code County 1 l/.�(`�jl/./� o {-L� Primary property owner contact name E-mail