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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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D;PREPARER,_ _-_
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Tide
219 N. Hart St.,P.O. Box 13 Partenheimer, Kinkle 8 Ricker
Address(Number and Street) Company
Princeton. IN 47670 812-386-0050 irkinkleehpk-law.com
City,State,and ZIP Code Telephone Number
E-mail
__ _. _— _— _.
E SEL'LER(S)/GRANTOR(S)t.` - �.__ _ _' ___ - _� ___ _
.Jerry Campbell Janirr Campbell Howell
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1221 N Main Street 1915 N SR 65
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 required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real.s Property Sales Disclosure Act".
)Sjl
r Signe of Seller Sig, tore of Selleri Q(-'-J $ �"i\V "[Q
•Jerry Campbell 9/25/2018 • Janice Campbell Howell 9/25/2018 •
Printed Name o(Seller Sian Date(MM/DD/YYY/1 hinted Name of Seller Siqn Date(MM/DD/17Y1)
Fe:BUXER(S)/GRANTEE(S)LaAPP,L'IGATION'F.OR'..PROP,ERTYLTAXiDEDUCTIONS IDENTIFY(ALL'ITE(>
LTHATIAPPIffi __-. -------
Mitchell
Ellis Amy Ellis
Byal-Nameas appears on conveyance document Buyer?-Name as appears on convryan 4LE D
2313 Outer Lake Road 2313 Outer Lake Road
Address(Number and Street) Address(Number and Street) SEP 27 2018
Princeton. IN 47670 Princeton IN 47670
Telephone Number (� E-mail
IFtsoN coon rr AUDITOR
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPL1.
YES NO CONDITION I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county:
2313 Outer lake Road ❑ ❑✓ 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Princeton, IN 47670 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 ❑ 11 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) f "Zb-12 --Oq-2csi7—000.274-024•
City,State ZIP code A l. Coun Mitchel Andrew Ellis etal
ty Primary p rop9 e owner contact name E-mail