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HomeMy WebLinkAboutHomestead_Kelly INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 i D:*P,R E P,A R E R`!-'. r ._ - z- S -•-ry^mar- .x -T- r: i - : -� i_t, ;:/;,. _ .. J -..sue.: Roman Ricker Attorney Prepa rer of the Sales Disclosure Form Tide 219 N.Hart St.P.O. Box 13 Partenheimer. Kinkle& Ricker Address(Number and Street) Company Princeton, IN 47670 812-386-0050 rricker(aihpk-law.com Ciry,State,and ZIP Code Telephone Number E-mail ESSalER(S)/,GRANTOR(S)} .' ;2z _. - _.. , '777 .,_.""7:': .. Clay I ankfnrd a/k/a Clay A I ankford Seller l-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 700 E Walnut Street Address(Number and Street) Address(Number and Street) Fort Branch IN 47648 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and cA mp lette as re red by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signa20ne of Seller Signature of Seller Clay I ankfnrd ark/a Clay A I ankfnrd 12/12/2016 Printed Name of Seller Sion Date(MM/DD/Yrrp Printed Name of Seller Sian Date(1.04/DD/rin7 rF_BUYER(S)%GRANTEE(S);-AP,P,L'IGATIONW..OR PROPERTtYrTAX DEDUCTIONS 'IDENTIFYiAI.ZITEMS THATrAPP,M Jordan T. Kelly Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 102 Ben Street,Apt.#1 Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 _ 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 ❑ 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: ❑ IN 700E Walnut Street 5.Wind Power Device Address(Number and Street) ❑ Q 6.Hydroelectric Power Device Fort Branch, IN 47648 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ Z 2.Does the buyer have a homestead in Indiana to be ❑ B.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Q 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) 2/0-i9_ is. - 30 y 000 y 8/ as Jordan T.Kelly City.State ZIPCade County Primary property owner contact name E-mail