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HomeMy WebLinkAboutHomestead_Mitchell INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 iD?PREPARERR. - - ,. —_ -: i- 7---7 Roman Ricker Attorney Preparer of the Sales Disclosure Form Tide P.O. Box 13,219 N.Hart Street Partenheimer, Kinkle&Ricker Address(Number and Street) Company Princeton,IN 47670 812-386-0050 rrickerehpk-law.com City,State,and ZIP Code Telephone Number E-mail•tE:,SBCLER(S)'/.GRANTO R(S)1 _s-- :_ --7:-: . 7.--;-- ,.L._ -• ' Clinton.I Coleman Krista D Coleman Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 6288 N SR 65 6288 N SR 65 Address(Number and Street) Address(Number and Street) Hazleton IN 47640 Hazleton IN 47640 Under pena ties of perjury,I h eby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co;(-�{te as re hired v,and is prepared in accordance with 6-1.1-5.5,"Real Property Sales Disclosure Act". Si•/a!N//re ofSller // Signature ofSe!el`�ler Clinton.1 Coleman 01/13(2017 Krista D Coleman 01/13/2017 Printed Name of Seller Sian Date(MM/DD/17110 Printed Name of Seller Sign Date(M.N/DD/YVYY) `1F BUYER(SpotANTEE(S); APPPLICATION.FORPROPERTYJTAXcbEDUGTIONSS;11 ENTIFY'AL'LL1ITEMS.,THAT _ ___ Elissa Danyalle Mitchell Buyer I-Name as appears on conveyance document Buyer 2 Name as appears on conveyance document y 1410 E. Poplar Street ✓., a�. Address(Number and Street) Address(Number and Street) r1 Petersburg. IN 47567 _ _ _ _ ��8, / THE YES SALES DISCLOSURE DOf10NM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS YES RROPERTt,.IDENTIFY ALL OF THOSE THAT APPLY. .1/. Q ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead '4 residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 6288 N SR 65 ❑ 1g 5.Wind Power Device Address(Number and Street) ❑ Q 6.Hydroelectric Power Device Hazleton, IN 47640 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ ❑ (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. /- ^ Not available in all counties.) C Address(Number and Street) o�t C5-/Q- /00 0 o Qy_J d/7 Elissa D.Mitchell City,State ZIP Code County Primary property owner contact name E-mail