Homestead_Kell (3) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
_De,PREPARER} i . - - .- t .J.Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Tide
219 N.Hart Street. P.O. Box 13 Partenheimer, Kinkle& Ricker
Address(Number and Street) Company
Princeton. IN 47670 812-386-0050 irkinkle@hpk-law.com
City,State,and ZIP Code Telephone Number
E-mail
E7.SELEER(SMRANTOR(S)1__ _ -, _ _ __ _ __ _ �___ -
Jeremy r) Ducharme
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
321 N Hall Street
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
E-mail Telephone Number E-mail
Under pe Ities of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as r q ired r y aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller
-ii III .ke me 10/1/2018
Printed Name of Sell- Sian Date OuM/DD/I1117 Printed Name of Seller Sian Date(MM/DD/rinl
( t.BIIYER616RAITEE(S)GAPP,h'ICAT,IOMFORiPROPERTY:PAX\i)EDUCTIONS-1DENrTIFKALLITEMSLTHATA@PL'Y. ..
Nathanael Kell Brandt Nicole Kell
Buyer I-Nome as app% rs on conveyance document Buyer 2-Name as appears on conveyance document
21 Main eet 213 S. Main Street
Address(A umber and Street) Address(Number and Street)
Hazleton. IN 47640 Hazleton, IN 47640
E-mail
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
Q ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ ❑✓ 4.Solar Energy Heating/Cooling System
residence,including county:
213 S Main Street ❑ 05.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Hazleton. IN 47640 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ VI 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Z 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 Sweet) 1^, �I /�' ^ fir�1 �p
Nathanael Kell d� el a .-1/4
`9 -w- o,(,,, 'b1 /
City,Stare ZIP Code County J '1
Primary property owner contact name E-mail