Homestead_Beasley INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D=.BREPARERit ;is `r r. __may ..ti�-°- S .....7P- - t .:- . ,..'-`: .
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 rrickernp hnk-law.com
Ciry,State,and ZIP Code Telephone Number E-mail
gE:SEliLER(S)/GRAN,TOR(S) m — i. , 7-7,'‘,7;77 `s , . .3
Timothy M Cooper Karla Cooper
Seller)-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
624 S Mohican Drive 624 S Mohican Drive
Address(Number and Street) Address(Number and Street)
Patoka IN 47666 Patoka,IN 47666
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and toes lete as required by law,and is prepared in accordance with IC 6 -rte "R pal Property Sales Disclosure Act".
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SignatureofSel-r Signature of Seller /
Timothy M Cooper 10/ IL /2017 Karla Cooper 10/ 1! /2017
Printed Name of Seller Sign Date(MM/DD/YVYY) Printed Name of Seller Sign Date(MM/Da/YYYY)
F.BUYER(S)T/6RAN TEE(S)LAPPLICATIONIEOR{PROP,ERTYhTAX?DEDUCTIONSzIDEN;TIEWAL'C,11(( T(•A'dP- t ell, '�: ..
John W.Beasley Doris J. Beasley i P, a H ,9
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
749 S. Barn Lane 749 S. Barn Lane OCT 13 ?0n
Address(Number and Street) Address(Number and Street) �"
Princeton, IN 47670 Princeton. IN 47670
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION
171 ❑ 1.Will this property be the buyer's primary ernsvM0 3.Ho
residence? Provide complete address of primary 4.Solar Energy Heating/Cooling System
residence,including county:
624 S Mohican Drive ID n 5.Wind Power Device
Address(Number and Street) ❑ (71 6.Hydroelectric Power Device
Patoka, IN 47666 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Z 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.
749 S.Barn Lane ��^^ 8 t v le ' a 1 unties.
Address(Number and Street) �Y/ v -� — oa
Princeton, IN 47670 Gibson John W.&Doris J.Beasley
City,State ZIP Code County
Primary property owner contact name E-mail
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