Homestead_Nelson (3) i
I
• INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
. ;15.9,.R-EPAREFtItA ..o' ;'.L,... . --'s -; s., - -
Britany N Barnes Agent
•
Preparer of the Sales Disclosure Form Title
226 W Broadway Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 Elniti6F7.4wc c.com
City.State,and ZIP Code Telephone Number 2 E-mail
r�[
I[1-.0 17
E.SELLER(S)/GRANTOR(S)
Kelly Wilder Hopper,Trustee -Tr% (4..st
Seller l-Name as appears on conveyance document Seller 2-,Name as appears on conrreya , m, Ty AUDITOR
814 N West Dr GIBSON COU
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660
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,a is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature ofS Jet Signature of Seller
Kelly Wilder Hopper,Trustee
Printed Name of Seller Sian Date(MM/DD/In]') Printed Name of Seller Sian Date(MM/00/IY7Y)
-F BUYER(S)/GRANTEE(S)=APPLICATION FOR PROPERTY;TAX DEDUCTIONS-'IDENTIFY ALL ITEMSTHAT APPLY : ,:l _
Amanda Dawn Nelson
Ir 1119I appears on[4eyange doyyien[ Buyer 2-Name as appears on conveyance document
A--revs(Nur-ber and S^// st (,/✓ (let( Address(Number and Street)
Jt '
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ I9 4.Solar Energy Heating/Cooling System
residence,including county: ❑
118 N Third St S.Wind Power Device
Address(Number and Street) LI IS 6. Hydroelectric Power Device
Oakland City.IN 47660 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
IN❑ 0 2.Does the buyer have a homestead in Indiana to be 111 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ IN 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)
aL - 1 (3—y156. —t6 :15? S — bcn
City,State ZIP Code County
Primary property owner contact name E-mail