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Homestead_Wornica
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER .. - . J. Robert Kinkle Attorney Preparer of the Sales Disclosure Form Tide 219 N. Hart St.,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 E.SELLER(S)/GRANTOR(S) . Rripn Ellis Kristen Fllis Seller I-Name as appears on conveyance document • Seller 2-Name as appears on conveyance document 12112 Petersburg Road 12112 Petersburg Road 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". ,' Z--- -\ - s s 1 _I " Am 0 A SSgnature of Seller Signature of Seller • Brian Ellis 4/26/2018 Kristen Ellis 4/26/2018 Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller l i I-1 M/DD/YYn) F.Bl1YFV r LGRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEM If�PPL.( i 7 Tara Elizabeth Womica - 1-Name as appears on cony ce document Buyer 2-Name as appears an conveyance docunMrA" AT 201� 156 N.Whitelock Ave..Ant.15 117 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. YES NO CONDITION I - NO CO I ,. 0 ❑ 1.Will this property be the buyer's primary I7] ❑ 3.Homestead residence? Provide complete address of primary IA 4.Soar tnergy Heating/Cooling System residence,including county: ❑ 5.Wind Power Device 916 S Washington Street Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ [ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ WI 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 ❑ 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) A-L' Tara Elizabeth Womica 2 es .-[0 -/7 -/01-O O?•t C�7 6b -6.18 Ciry,State ZIP Code County Primary property owner contact name E-mail