Homestead_Lanman (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER .- ,..., '
Ray M. Druley • Attorney No.4759-26
Preparer of the Sates Disclosure Form Title
505 N.Church Street, PO Box 146 Law Office of Ray M. Druley
Address(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 drulevlawevahoo.com
City.State,and ZIP Code Telephone Number E-mail
E:SELLER(S)/GRANTOR(S)." ` - '':C?;,. t `:,_.-_.' : '
Joyce A Kemper
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1130 S Seminary
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 by law and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
i L.(i ��,4- 1�4—e—A)
Signature ofSellei/ / t / Signature of Seller
Joyce A Kemper 11/22/2016
Printed Name of Seller Sign Date(MM/DD/YWI) Printed Name of Seller Sign Date(MM/DDfflt)
F-BUYER(S)/GRANTEE(SS)-APPLICATION FORP.ROPERTY-TAX
❑ 1.Will this property be the buyer's primary Urn 3.Homestea
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heming/Cooling System
2
residence,including county ❑ 0 5.Wind Power DeVIW 3 0 2u ID
7 t/� tit lL-,. r o $ t
Aggres? umber and*yet) J �// n 0 6.Hydroelectric Po er Device
f Yt 2 4 C C o74 J'i / e7eGibson ❑ 0 7.Geothermal En (� r�''{y oling Device •
Ciry,State ZIP Code County GI rer`�[21C 9
❑ 0 2.Does the buyer have a homestead in Indiana to be
❑ I,7 8. Is this propel c1 [21 t6l4Mrfa$perty?
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.
. ! 1 Not
�TCYavailable liin all cctoouu�nties.)UL �y
Address(Number and Street) Qb-l.a-i v- a0 1-Dot. ic•oa V
City,State ZIP Code County l.X
Primary property owner contact name E-mail