Homestead_Adcock •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Steven L.Whitehead Attorney
Preparer of the Sales Disclosure Form ,. Title
. .
111 N. Hart Street ,
Address(Number and Street) Company
Princeton. IN 47670 .. 812-386-5040 whiteroc2r@amail.com
City,State,and ZIP Code - Telephone Number E-mail
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John Taylor Adcock
Seller!-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
913 S Hall Street
Address(Number and Socet) Address(Number and Street)
-I
Princeton IN 47670
Under penalties of perjury,Thereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a ■ o letepf equired bylaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
...,
„-Signature of Seller Signature of Seller
.., 0-7-03-/i
...1011aa,V161SEICIS .- ,. . -. - . . .
S. Sian Date(Iiii/DD/117Y) Printed Name of Seller - ' SignDate(Stit/PCP/WiY)'
Printed Name of Seller
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John Taylor Adcock .. Ou Yan
Buyer 1-Name as appears on conveyance document Buyer 2'Name as appears on conveyance document
• 913 S. Hall Street 913 S. Hall Street .
Address(Number and Street) :
Address(Number and Street)
5 •
Princeton, IN 47670 Princeton, IN 47670
..
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
.
; TA Li 1.Will this propery be the buyer's primary 0 12 3.Homestead
residence? ProVide complete address of primary 0 Is 4.Solar Energy Heating do mg y em,-- . /
. residence,including county: - •. • .
P 0 12 5.Wind Power Device .
913 S Hall Street ' MAY 2 3',2018 '
Address(Number and Street) :: Li TA 6.Hydroelectric Power Device
Princeton, IN 47670 i; Gibson Li 151 7.Geothermal Energy HeatiwJCqoli Dflice-
City,State ZIP Code County
8.Is this property a reside rty_?
0 19 2.Does the buyer have a homestead in Indiana to be 0 IN GIBSON COUN UDITOR
vacated for thisresidence? If yes,provide Li 151 9.Would you like to receive tax statements tor 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)
.-_ d G- I 2-i R- 10■-ona gs) -0,28
City,State ZIP Code - county
-i Primary propertyownercontact name E-mail
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