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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 IDMIREP,ARERj r-'',,"11... -'° -ow-, s ':.1•_ :'S -t.-. e : 54 -Yes ..' `! ' _ . - - 7 J.Robert Kinkle Attorney • Preparer of the Sala Disclosure Form Title 219 N. Hart St., P.O. Box 13 Partenheimer, Kinkle&Ricker Address(Number and Street) Company Princeton, IN 47670 812-386-0050 irkinkle(dhpk-law.com City,State and ZIP Code Telephone Number E-mail §,EKSELLER(SAGRANTOR(sop. y. _w, at, ;z., >;. . .,. ; ,:.-t-': Y_'.;. r^t ,%- ! r i r v- x':_:„° ., Tamara S Hayes Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document S05 S 9th Avenue 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 aghdd complete as re uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". J(�1nvtaAa S I Signature of Seller ? Signature of Seller 1 Tamara S Haves t•3/O?° Printed Name of Seller Sign Date iiMM/OD/1'YYY) Printed Name ofSeller Sian Date(MM/DD/m9') FlBU,YER(SithGWINTE_E(S) 'AP,P-11GAclile FLOR1P,R0PERaMiD.ED.U-C-Til oNS`iilPENiTIF;Yr't\LL9ITjEMS}iTIHAVAR81!:Yr ""A ":=:J The Shirley Ann Farmer Revocable Inter Vivos Trust dated 8-30-06 Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance 2591 Glen View Drive Add Address(Number and Street) Address(Number and Street) Pacific, MO 63069 4.pa THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY AMIS.• . �.;TAP`Y. YES NO CONDITION. YES NO CONDITION NC1 V :Ii 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead )'AVM/ residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling tem residence,including county: ❑ IN 505 S 9th Avenue S.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIPCode County I ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.1s 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. / Not available in all counties.) Address(Number and Street) Zip— 0?3-o -12cc rtes„ p/ O 009 Shirley Ann Goeke Revocable Inter Vivos ciao C7 C7 City,State ZIP Code County Primary property owner contact name E-mail