Loading...
HomeMy WebLinkAboutHomestead_Tully INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 -- .7 r = yr -- _'D�PRE$ARER! :<-�� ��, ,. sF. _.r y:l' �` :1_e..,. �:�r3 ._,— Roman Ricker Attorney Preparer of the Sales Disclosure Form Title 219 N.Hart St., P.O. Box 13 Partenheimer,Kinkle&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 'E ,SELLER(S)%GRANTOR(s)T x -_ 'v.. __ , '' -+_F Daniel F Ellerbrook Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 415 F Oak Street Address(Number and Street) Address(Number and Street) Oakland City IN 47660 City,State nd ZIPCode City,State,and ZIP Code -I ( 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 corplete as cegui�by law,and is ared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seller Daniel F Fllerhmok y�2/2 Printed Name of Seller Son DatLL,(MM/DD Printed Name of Seller Sian Date(MM/DD/YYYn iE?;BUYER(S)/GRANTEE(S)_ AP.P.LICATION;FOR P�aOERTIVEAX DEDUCTIONS IDENTIFYIALthiTEMS_THATI.ARPLAO - - Andrew A.Tully Buyer I-Name as appears an conveyance document Buyer 2-Name as appears on conveyance doalent 427 S.Hall Street 1q � Address(Number and Street) Address(Number and Street) sY Princeton, IN 47670 Q�L ;�g City State and ZIP Code City,State,and ZIP Code / APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THATt��),.C.r-c.j A-/tit YES NO CONDITION YES NO CONDITION UIA CY19Sn,a C-' El 1.Will this property be the buyer's primary 0 ID 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy item residence,including county: . �' 415E Oak Street ❑ ❑� S.Wind Power D. Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Oakland City, IN 47660 Gibson ❑ Yj 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County 0 ill2.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 ❑ ❑ 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. 427 S. Hall Street Not available in all counties.) Address(Number and Street) Princeton, IN 47670 Gibson Andrew A.Tully —(�t0- I� -I g- �1'D�-11)( a33 City,State ZIP Code County /� Primary property owner contact name r�-.+i 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".(Note: Last 5 digits of Buyer 2/Spouse Driver's State Last S Digits of Social Security License/ID/Other Number Number License/ID/Other Number