Homestead_Cooper (4) I
I
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
yDYPREPARER I -, -,T.ask,, k71... .-6. '- •� `IP7 rr r-- i+: - lm—rg__` t,,
Leon C. Stone President
Preparer of the Sales Disclosure Form Tide
226 West Broadway Street Broadway Title. Inc.
Address(Number and Street)
E-mail
:E'SELhER(S)`/.GRA'NTOR(S)L-3.:._: `r .'>•'r. _ Y-` _� _t._ z'l;;^3. .-_" =:-w. -_ s-.._r �.°$- Sf . . u'2;-“,V
Fldnne L Barrihall Cynthia L Barriball
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
I 115 East Center Drive 115 Fast Center Drive
Address(Number and Street) Address(Number and Street)
Oakland City IN 47660 Oakland City IN 47660
City,State,and ZIP Code City,State,and ZIP Code
Telephone Number E-mail Telephone Number E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as require y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
F1 � �6ILuv/ C'y d° eLti —
Signature of Seller Si 'azure of Seller
Fldnne I Rarrihall 'i&CS, 0 / `7 Cynthia L Barriball 4 - 3° -026 i 9
Printed Name o,$eUer Sian Date(MM/DD/vm) Pdnt e Sian Date(MM/DD/YYYY)
_F. . R(S)/GRANTEE(S)-A . CATION:FOR<?PROPERTYJTAXD CTIONS._IDENTIFTEMSTH A — .-- z: • -
Christo her Ch des Co er Mahala Gabnat•C000er E"'7-.
Buy enl u er 2 eya doe'sJJJuuu
122 East Mill Street 122 East Mill Street- ._ Address(Number and Street) Address(Number and Street) MAY 2 2019
C Oakland City, IN 47660 Oakland City, IN 47660
City,State,and ZIP Code City,State,and ZIP Code
(
GID0O'�COUNT' Y AI RIITORE-mail
THE SALES DISCLOSURE FORM MAY DE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROP . I NTIFY ALL OFT I APPLY.
YES NO CONDITION 'ES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of prima M N . , - 3 _ - ' g/Cooling System
residence,including county:
115 Center Drive ❑ ❑✓ S.Wind Power Device
Address(Number and Street) 0 Q 6.Hydroelectric Power Device
Oakland City, IN 47660 Gibson 0 7 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ j 2.Does the buyer have a homestead in Indiana to be ❑ Ej 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 121 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: w. 'ons for more information.
Not available in all counties.)
Address(Number and Street) li 14— 1 ^^L/31 1 • V:t1 _ °DT- •
CityState LP Code County
Primary proper owner rontnr , ,
r