Homestead_Peterson INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:,P.REPARE _.�. -1 r� ,-717-_ 'r t i.'_ ' .-. - - :. '_.s_— - i
Roman Ricker Attorney
Preparer of the Sales Disclosure Form Title
219 N. Hart St., P.O. Box 13 Partenheimer. Kinkle&Ricker
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050 rrickerehpk-law.com
City,State,and ZIP Code Telephone Number Email
Ei. EL'CER S GRANTORS - -
John W.Beasley Doris,I Beasley
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
749 S Barn l ane 749 S Bam l ane
Address(Number and Street) Address(Number and Street)
Princeton IN 47670 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 co plete as re 'red by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act",
�
nature o Seller S gnature o Seller
John W Beasley 10/11/2017 Doris J Beasley 10/11/2017
Printed Name o(Seller Sign Date(MM/DO/YYYYI Printed Name of Seller Sign Date(MM/DD/Yrvp
.:,BUYERN I/.GRANTEE(s)L_ABP,LICATION!F,ORP.ROPERTYTAxi DEDUCT[ONS=IDENTIFY TAILITEMSITHAT`AP,PLYt. .T�-ti_ J
Jared D. Peterson Amanda L. Peterson _
Buyer l-Name as appears on conveyance document Buyer 2'Name as appears on conveyance docu en
11712 Steamboat Dr..Apt, 2129 11712 Steamboat Dr..Aut. 2129 I' h '
Address(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TH gps,�[As6E N C" ,!!y
l li tsaU COUNTY :t,IDITOR
YES NO CONDITION YES NO CONDITION
p ❑ 1.Will this property be the buyer's primary z ❑ 3. Homestead
residence? Provide complete address of primary ❑ 2 4. Solar Energy Heating/Cooling System
residence,including county: ❑ El 5.Wind Power Device
749 S Barn Lane
Address(Number and Street) ❑ El 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ Izi 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
ig
❑ El 2. Does the buyer have a homestead in Indiana to be El 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ El 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.) n�/� /�/�
Address(Number and Street) ../G-� I I- I - —� .( 7/ ?-t( l9- 7
Jared D.IIILLL&.. Amanda L.Peterso PerrssoV7r/`_/ J l/ ( l/C� r
City,State ZIP Code County
Primary property owner contact name E-mail