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HomeMy WebLinkAboutHomestead_Lewis (17) I INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 P,REPARORI , :`-?x!a ;.- "14_ - - *• . ' `' •, 'ST 7777::7:71' _:- -- _❑ J. Robert Kinkle Attorney Preparer of the Sales Disclosure Form Title 219 N. Hart Street, P.O. Box 13 Partenheimer, Kinkle& Ricker ' Address(Number and Street) Company Princeton, IN 47670 812-386-0050 jrkinkle@hpk-law.com City,State,and ZIP Code Telephone Number E-mail £aSELEER(S)%GRpNrTOR(S),-.: „ ` - -1-T - '-. -7'.-77,7.7-- • -.---r-s---l.- —j _Charles R I Pwis Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document 6fBV -. . 4 Sr ( l 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 c tea gyire y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seller Charles R I ewis 2/26/2018 Printed Name of Seller Sion Date(MM/DD/YYY) Printed Name of Seller Sion Date(MM/OD/YYYY) F1:BUYER(S/GRAN,TEEo SAP.P,EIG pN(F,OR±EROP,ERTIYtiTAXQD.ED residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ S.Wind Power Device 305 W Strain Street Address(Number and Street) ❑ Q 6. Hydroelectric Power Device Fort Branch, IN 47648 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County Ill 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ I71 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. Co- GNot available in all counties.) / Address(Number and Street) 2.. C I p -a y _ac 5/ - °co 3 9 c a 47 Steven M.Lewis City,State ZIP Code County Primary property owner contact name E-mail