HomeMy WebLinkAboutHomestead_Elliott (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Roman Ricker Attorney
Preparer of the Sales Disclosure Form Title
P.O. Box 13,219 N. Hart Street Panenheimer, Kinkle&Ricker
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050 rricker(@hpk-law.com
City,State and ZIP Code Telephone Number E-mail
�ES,SELCER{S)/GRANTOR[S) i. ' _
Jonathan C Camma'Pr
Seller I-Name as appears on conveyance document Seller l-Name as appears on conveyance document
302 S Hillcregt Stree:
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
and comp a as required b • • 1L1 is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
,Innathan C Carpan:er 17/28/2016
Printed Name of Seller Sian Date(M.N/DD/IT{T) Printed Name of Seller Sian Date(•0400/Meet
,Fi.BUYER(S)/GRANTIi E(S)`u AFPI.ICA'PION FOR`PROPERTI'TAX DEDUCTIONS-.IDENTIFYr'ALI {TEMS THAT APPLY„': '-'
Chelsea Elliott
Buyer I-Name as appmr on conveyance document Buyer 2-Name as appears on conveyance docuJ,
651 S. Concord Drive
Address(Number and Street) Addrn.(Number and Street)
THE SALES DISCLOSURE.FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TIIIS PROPERTY. IDENTIFY ALL OFTIIOSET AT.'- ,V .
YES NO CONDITION I YES NO CONDITION 'Yid
El ❑ 1.Will this property be the buyer's primary ❑ ❑ 3. Homestead q(/p/T
residence? Provide complete address of primary ❑ M 4.Solar Energy Heating/Cooling Syst&A1
residence,including county: ❑ ❑ 5.Wind Power Device
302 Address S Humee a Drive Mr� 6.Hydroelectric Power Device
Address(A'umberand Street) ❑ ,rl y
Fort Branch, IN 47648 Gibson ❑ ❑ 7.Geothermal Energy Heating/Cooling Device
City,State Z/P Code County
❑ z 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 ❑ M 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.
a of available in all counties.)
Address(Number and.Street) ol.f/ — / -/ 57. /0a- 060059- 6076
Chelsea C.Elliott
Ciry,State ZIP Code County
Primary property owner contact name E-mail