Homestead_Dunchame INDIANA SALES DISCLOSURE FORM SDF ID: Paget
aD RAE$ARER1':;: T :>_ . -•rl ,,l,ia 2 • :. '• r_<_ l
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Title
219 N.Hart Street, PO Box 13 Partenheimer, Kinkle&Ricker
Address(Number and Street) Company
Princeton. IN 47670 812-386-0050 irkinkle(alhpk-law.com
City,State,and ZIP Code - - Telephone Number E-mail
MisELLER(S)/.GRi1N!TQR(S)) - - s . .t' f ; .- ,_ 7777-. "—, _ rt
Scott D Patterson — Holly A Patterson
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
.8099 N.50 W. 8099 N 50 W
Address(Number and Street) Address(Number and Street)
Hazleton IN 47640 Hazleton IN 47640
City,State and ZIP Code City,Stale and ZIP Code
correct
an omplete as re ired by and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
(4. /2
Signature of Seller Signature eySeller
Scott D Patterson 12/14/2018 Holly A Patterson - 12/14/2018
Pr/' , Sian Date(MM/DD/YYY11 Printed Name ofSeller Sian Date(MM(DP/MO
k iBU;YERMY,,GRANTEE( ' PPUIUAT;IOHjROR1RRO$ERWX6TrAMI)EDUCTIQNS IDENTIF,YiALLLOE ARP,• OIL ` I
Luke D�channe
err-Nnmenc aa on., _Omveya ' J
document Buyer Name as appears on conveyance document
803 N.West Street DEC 1 7'7(118
Address(Number and Street) Address(Number and Street)
Princeton. IN 47670
City,State.and ZIP Code City,State,and ZIPCode
FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THISp&erEHfr IDENTIFY ALL OF HAT APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary ❑ ❑ 3.Homestead
residence? Provide complete address of prima �ergy Heating/Cooling System
residence,including county:
rj IA
104 E Spring Street 5.Wind Power Device
Address(Number and Street) ❑ 2 6.Hydroelectric Power Device
Patoka, IN 47666 Gibson ❑ 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
❑ 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 ❑ WI 9.Would you like to receive tax statements for this
complete address of residence being vacated, rty via e-mail?(Prow ct information
including county: below.Please see instructions for more mation.
1 Not available in all counties.) rZ
Address(Number and Street) �V — 2 3Q4—. OOo- ` 6 ° `v
Luke Ducharme
City.State ZIP Code County
my property owner contact name E
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best o m e,correct
Number License/ID/Other Number