Homestead_Black •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
iRREP:ARERIr 'f_ ,:- —.-• t- — ;. . : - .d•F --3 :.`�`;2.a. . F #= 'S` -�
Leon C. Stone President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title. Inc.
Address(Number and Street) Company
Princeton, IN 47670 (8121 386-1687 bti(almw.twcbc.com
City,State,and ZIP Code Telephone Number E-mail
tE45ETLER(SAGR/AN TOR( I,.-st,' '7.'.;., !7. -tr.... .+ .,-man xy.x_ t,�.-.•..-.., r- :77.'4',4 ti. -r-• .:77; �i -.;
Richard P Mendenhall Kayla S Mendenhall
Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
68795550W 6879 5550W Trs n Y 171 �li `
Address(Number and Street) Address(Number and Street) 11I J1
1 Ili
Owensville IN 47665 Owensvilie IN 47665
Telephone Number E-mail Telephone Number E-mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledggand belief;ds-true,correct
and complete a required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real rrooppeerfy.Sales Disclosure Act".
I?- k,JP • / / // I/ - (t S Me�� ^ ON COUNTY AUDITOR
Signature of Seller .•(.L�J,/(-( p' Sig re of Seller
�
Richard P Mendenhall /INb/J Kayla S Mendenhall 07Vy77.4)tg
_PH eo_Seller Sian Date(MM/DD/mT) Printed NameyLreno• Sian Date(MM/a0/Y-Yn
` !BUYER(S /,GRANTEE(8JIFAB ,MGATIONIF,ORVOP:ERTIYITAxIDEDU 81NiDEN,TIE ALL uT WIT A-I TyTAP$itYi ..
Curtis-A R1 ark l)
Buyer I-Name as appears on cones acumen( Buyer 2-Name as anent
40 Thumps-an Laue - b ROX 25f
Address(Number and Street) Address(Number and Stre t)
Owensville. IN 47665 ?fit-oga 476(o4,
YES NO CONDITION YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3. Homestead
residence? Provide complete address of prima gy Heating/Cooling System
residence,including county:
6879 S 550 W ❑ 0s.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Owensville, IN 47665 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 ❑ 0 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) L^ ` — 1 VX f_``8 _2O\D —00k • 4.2—O— O �\:
City,State ZIP Code County /V_ E-mail
Primary property owner contact name