Homestead_McClaflin INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
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 irkinkle(dhnk-law.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTER(S) '
Jane McClaflin
Seller I.Name as appears on conveyance document Seller 2-Name as appears on conveyance document
527 S. 9th Avenue
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete
asTe ird
nil-Fri by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
nature of Seller C V Signature of Seller
Jane McClaflin 09/N/2017 ,a _
/YYYY
Printed Name o(Seller Sian Date(MM/DDI Printed Name o/Seller _ Si lit IMM/DD/YYI'YI
F.-BUYER S GRANTEE(S) APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL I S IRi•.F(P,LYO
teve McClafli 3
2`` 2 3 Buyer l- ame as appears on conveyance document Buyer 2-Name as appears on conveyance dap@Ibf,t 101/
7710 N. Shiloh Church Road
Address(Number and Street) Address(Number and Street) 4
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES _NO rONDITION
❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of primary ' u U 4.So ar nergy Heating/Cooling System
residence,including county:
❑ ei 5.Wind Power Device
Address(Number and Street) ❑ la 6. Hydroelectric Power Device
City.State ZIP Code County ❑ 12 7.Geothermal Energy Heating/Cooling Device
❑
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 ❑ ❑ 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)
Gibson ottp - o5-57 • 0 0 0 0. 5 5 6 - 0/ 7
City State ZIP Code County
Primary property owner contact name E-mail