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Homestead_Matheis
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 J.. Robert Kinkle Attorney Preparer of the Saks Disclosure Farm Title 219 N. Hart St., P.O. Box 13 Partenheimer. Kinkle& Ricker Address(Number and Street) Company Princeton, IN 47670 812-386-0050 irkinklea@hpk-law.com Ciry State,and ZIP Code Telephone Number E-mail IIL:SELCER(S)%GRANITOR(S)I . `• > . 7,---. T-77.-7--"' -. I I Mark R Kissel Amy J Kissel I Seller 1-Name as appears an conveyance document Seller 2-Name as appears on conveyance document i 40255 125W 40255 125W Address(Number and Street) Address(Number and Street) Princeton IN 47670 Princeton IN 47670 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 re mr by law,and is prepared in accordance with C 6-1.1-5.5 "Real Proper Sales Disclosure Act". 14,41 II; Signature of Seller Signature Iles Mark R Kissel 3/7/2018 Amy J Kissel 3/7/2018 Printed Name of Seller Sian Date(AUt/DD/YYY1) Printed Name of Seller Sian Date(MM/DD/YYYf E$UXER(S)/GRANTDEE(S)LARREIGAT10NfF0R?PtROPERTEVFiXI DEDLETilONShlD..E Nall F,,YE BEAMEMSOHATARREW - ' • 1I Elliott Jacob Matheis Buyer 1-Name as appears an conveyance document Buyer 2-Name as appears on conveyance document _ 1761 E. Michigan St.,Apt. D Address(Number and Street) Address(Number and Street) THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.f1 .O G U YES NO CONDITION YES NO CONDITION Q ❑ 1.Will this property be the buyer's primary Q ❑ 3. Homestead IIrimir, residence? Provide complete address of primary ❑ © 4.Solar Energy Hea I Roonng system UDITOR residence,including county: 104 E.Vine Street ❑ IN 5.Wind Power Device 'Address(Number and Street) ❑ Q 6. Hydroelectric Power Device Fort Branch, IN 47648 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 ❑ 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ IZ 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.) 2� //� Address(Number and Street) C9i— /g-13-1104-ego' , JfLe/1 W�CC�;J Elliot Jacob Matheis City,State ZIP Code County Primary property owner contact name E-mail