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Homestead_Masters
• • INDIANA SALES DISCLOSURE FORM f SDF ID: Page 2 r;D,PIRERARERte'I n-44,1 s•""'L•.'.•c.<. . •HC- . '.ram, ..="..^T.., :, „ 3r. • ?•a. - Y.-.:.. . . - ,•P-, ,'4*.-7-1 Roman Ricker Attorney Preparer of the Saks Disclosure Form Title 219 N Hart Street Partenheimer, Kinkle 8 Ricker _ Address(Number and Street) Company Princeton, IN 47670 812-386-0050 rricker@hpk-law.com City,State,and ZIP Code Telephone Number E-mail 13E'•¢SELLER(SAGRANiTkOR(S)1=i.=: a a c'Zte.t- . :— 7114. r..; 33'..: -7k • ,•... 1`-- "T— - .•-ct;' I Daniel F Colbert Jennifer t Colbert Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 9587 W 575 S 9587 W 575 S Address(Number and Street) Address(Number and Street) Owensville, IN 47765 - Owensville IN 47765 � � Telephone Number E-mail Telephone Number E-mail Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and pl as r u aw,and is prepared in accordance with IC - 5,S "Real Pro erty Sales Act". Signature of Seller Signatue Seller ) 1 - Daniel 12/5/7018 Jennifer Colbert 12/5/7018 • ted Name of Seller Sian Date(MM(OD/YYY1) Printed Name of Seller 1 MM/DD/YYYt7 rJai iERMGRARTEE(S)f;APP,LTGATIONf$OR1PIROP,ERTIYCTAXfDE H-,ilON5'�'IDENTIF,I'2A • ;T r. 5;1;i'tI CAP , r� t=� 4 :'i s i An ela . Ma E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO'tr '.IDENTIFY ALL 0 •. . .AT APPLY. YES NO CONDmON NO CONDITION IZI ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead residence? Provide complete address of prima Q © 4.5 •- _, eating/Cooling System residence,including county: 9587 W 575 S - is 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Owensville, IN 47765 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County 0 ❑ 2.Does the buyer have a homestead in Indiana to be ❑ ID 8.Is this property a residential rental property? - 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. 5136 S.Washington St. Not available in all counties.)Address(Number and Street) �7 Oakland City IN 4 660 Gibson a\ — 1-1 -09' �-110 -0ok .04- S-Q2_1 _ City,State ZIP Code County Primary property owner contact name E-mail