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Homestead_Wilkerson INDIANA SALES DISCLOSURE FORM SDF ID: ' Page 2 J. Robed Kinkle Attorney Preparer of the Sales Disclosure Form Title 219 N. Hart Street Partenheimer, Kinkle& Ricker Address(Number and Street) Company Princeton, IN 47670 812-386-0050 jrkinkle@hok-law.com City,State,and ZIP Code Telephone Number E-mail • LEsSE SER(Sj',GRANTOR(S))E'", a. . — _- P - -7-----" __,__ - Thomas L. Simmons Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 6947 S 1675 W Address(Number and Street) Address(Number and Street) Griffin, IN 47616 E-mail Telephone Number E-mail 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". 7L -1 , Signature of Seller Signature of Seller Thomas L. Simmons 10/ /2018 Printed Name o Seller Sign Dote(M /Y M/DDYYY) Printed Name ofSeller Siqn Date(MM/DD/YYYY1 LEC •1 !ER(S)/G RANI 1- —:AP,P.LEICATION►FQRIP,ROP,ERTIYLTAXiDEDUCTIONSLL+IDEN'rTi1FYGAIIUTIEMSiTiiHATi/AP,P,L'17 J Michele L.Wilkerson w gggg nt �� Buyerl-Name as appears on yanre document Buyer 2-Name as appears on wove etl�u Address(Number and Street) Address(Number and Street) gg Griffin, IN 47616 OCT 11 2018 E-mail Telephaneflu M. _ I • '+�+11'�1�j1.( AUDITOR E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P ERTY. IDENTIFY ALL OFG rTAPPLY. YES NO CONDITION YES NO CONDITION ❑✓ ❑ 1.Will this property be the buyer's primary ❑✓ ❑ 3. Homestead residence? Provide complete address of primary ❑— 4 tiohr rnergy eating/Cooling System residence,including county: ❑ 5.Wind Power Device Address(Number and Street) ❑ © 6. Hydroelectric Power Device ❑ ❑✓ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 2 8. Is this property a residential rental property? ❑ ❑✓ 2. Does the buyer have a homestead in Indiana to be vacated for this residence? If yes,provide ❑ ❑ 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) Gibson t/-26 — 1{I 61 2_fill _700 -at . )82 -on- City.State ZIP Code County Primary property owner contact name E-mail Number License/ID/Other Number