Homestead_Smith (5) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
:D.PREPARER :'..i. ,._ ,t4 . .. .
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Tide
219 N. Hart Street Partenheimer, Kinkle& Ricker
Address(Number and Street) Company
Princeton,IN 47670 812-386-0050 irkinkle(Whpk-law.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) • - - .
Gary K. Smith
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10956E50N
Address(Number and Street) Address(Number and Street)
Oakland City. Indiana 47660
E-mail Telephone Number E-mail
Under p alties of perju ,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co plete a qui d by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
TT
Slgnatu of Seller ` Signature of Seller F I_Iham/E D
Gary K. Smith 11/.5/2018
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name o/Seller nr r• rah Data Ngf/DD/vrvtl
.F.:BUYER(S)'�NTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY-ALL ITEMS THAT XPP7,\ '- Pt
if
M. Smith Francis M. Smith y if�
uyyer 1-home as appears on conveyance document Buyer 2-Name as appears on conveyance document IMnrl ��
8791 S SR 57 8791 S SR 57 GIBSON COUNT`/ AUDITOR
•Bd y� eaCdbree) I 3 tar eizg�ag Street)
•Bucksleci, Indiana 4764 8uGk5sD, I diana-47 8fi- `/- to/3
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 YES N ONDITION
❑✓ ❑ 1.Will this property be the buyer's primary ✓ ❑ 3.Homestea
residence? Provide complete address of primary ❑ ( 4.Solar Energy Heating/Cooling System
residence,including county: ❑ E 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
❑ 02.Does the buyer have a homestead in Indiana to be ❑ E B.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.
Not available in all counties.)
Address(Number and Street)
Gibson A 4 _ Ao - as - /oo - oo0.546.3 -oo/
City,State ZIP Code County
Primary property owner contact name 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:
License/ID/Other Number Number License/ID/Other Number