Homestead_Kelley INDIANA SALES DISCLOSURE FORM SDFID: Page 2
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Timothy Shea Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
City,State,and ZIP Code Telephone Number E-mail
11':o10. . —
Linda L.Wallace
Seller 1-Name as appears on conveyance document Seller I-Name as appears on conveyance document
1108 N Main Street
Address(Number and Street) Address(Number and Street)
Priinceton,DI 47670
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 i accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
1 (71140
i
Stianature of Seller' (� Signature of Seller
Linda L. Wallace,By Michael A.Watkins,AIF .JI'U���
Printed Name of Seller Sign DaS M/DD/YI'YY) Printed Name of Seller Sign Date(MMpO )
aF.isBUYERfSIT/GRANTEEGSI�AP.P.I:[GATIONdF.OR+!P.ROP.ERfliYcTAXtDEDUC-TION S�'1 DENTIgIJALffiITEMStTiHAVAP.P.LYs�`r�w..�..�.,..,,,
Amy J. Kelley
Buyer l-Name as appears on conveyance document - Buyer 2-Name as appears on conveyance document
3250 N Shamrock Lane
Address(Bumper and Street) - - _ Aaaress(Number and treet)
Birdseye,•fN 47513-9341
THE cuu PS DISCLOSURE FORM MAY DE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. Mar 19 2019
Y�ES, NO COND ON NO CONDMON
L� /❑ 1.Will this property be the buyer's primary YES ❑ 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary ❑ B 4.Solar Energy Heating/Cooling System
residence,including county: ❑
110I�1 Stormont Street 0 S.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Princeton,IN 47670 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,slate ZI e County ❑ lit 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ B .9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
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) Amy J. Kelley. 26-12-07-204-000 . 128-028
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
Number License/ID/Other Number