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Homestead_Cook (2)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Roman Ricker Attorney Preparer of the Sales Disclosure Form Tide 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 Cade Telephone Number E-mail !E::SEEEPT .)%GRANTOR E—• ---- -----7 - - . r--. - — . - —-71 Jerry W Harrington Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 11518E 200S Address(Number and Street) Address(Number and Street) Under penalties of perjury, hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and com lete as required y 1 is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signora of Se Signature of Seller Je Harrington 10/27/2017 rinted Name ofSeller Sian Date(MM/DD/YYYY) Printed Name of Seller ate(MM/DD/YYFYI IFrB.LIXER(S)/GRANTEE(.)dPPElGAT10NiFOR iRROPERTtYLTAMDEDUGTIONS IDENITTF,WA EJTEMS:THATtARPrL ' ,¢- - ^j Gary L. Cook Belinda E. Cook '4' Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document Neen 545 Country View Lane 545 Country View Lane N�(/1 `' �$t, Address(Number and Street) Address(Number and Street) Ghent, KY 41045 Ghent, THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. ci/f04, YES NO CONDITION YES NO CONDITION Q ❑ 1.Will this property be the buyer's primary Q ❑ 3. Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 11518E 200 S ❑ 12 5.Wind Power Device Address(Number and Street) ❑ z - 6. Hydroelectric Power Device Oakland City, IN 47660 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 2. Does the buyer have a homestead in Indiana to he ❑ 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 1 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) A. /54_,q_ /O3_Joo.Of-a6 ' Gary L.Cook and Belinda E.Cook City,State ZIP Code County Primary property owner contact name E-mail