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Homestead_Smith (79)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D P.REPARER.- .1 �_ :,--- -- -- ) Roman Ricker Attorney Preparer of the Sales Disclosure Form Tide P.O. Box 13,219 N. Hart St. Partenheimer, Kinkle&Ricker Address(Number and Street) Company Princeton, IN 47670 812-386-0050 rricker @hpk-law.com City,State.and ZIP Code Telephone Number E-mail . 7c•=•-- 7- --II.. .�. ��.7 T.a • _ ;_ri �E?.SEL•LER(S)%GRANT,OR[5)'L_� _ -. ------� _ _ '.- .' - . . . __ Thomas Joseph Philomina 0 Thuruthumay Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1707 Brentwood Drive 1707 Brentwood Drive Address(Number and Street) Address(Number and Street) Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature�of Seller - Signature of Seller IA. �(S1o• rn :PAWS k . II o1 2v12 PhilominaO Thu' Siu L !!1 1 Phn'ted I'?[-ell r Sian'Date(MM/DD/YYYY) Printed Name of Seller SianDatuIMM/DD/YYYn F:BUYER(SJ RAN;TE )LAPPLICATIONIF,QR PROBERTiYITAX∎DEDUCTIONSiIDENTIFY!ALL' ITEMS,T,HATcAPPL'W_ '- '.] Buyer I-NaG.me Smith Sherri L. Smith I - Buyer?-Name as appears on conveyance document Buyer2-A'ameas appears on conveyance document 1121 S. Race Street 1121 S. Race Street ir Address(Number and Street) Address(Number and Street) b THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. O6ti YES NO CONDITION YES NO CONDITION l�a, `-..„ 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead .,J/TOR residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence, including county: 1707 Brentwood Drive ❑ ig S.Wind Power Device Address(Number and Street) ❑ 0 6. Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County 0 ❑ 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 ❑ 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. 1121 S. Race Street Not available in all counties.) Address(Number and Street) , , —/ a -04'-901-0o/. 77o -oetb' Princeton, IN 47670 Gibson Kenneth G.8 Sherri L.Smith City,State ZIP Code County . Primary property owner contact name Email •