Homestead_Straw (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
.D.P.REPARER • -. _- i' sri-i, ;" s... -z .. r. -. - . . - .
James G.McDonald, Ill Attorney at Law
Preparer of the Sales Disclosure Form Title
120 S. Main Street McDonald Law Office
Address(Number and Street) Company
Princeotn, Indiana 47670 812-385-4816
City,State,and ZIP Code Telephone Number E-mail
E.SELLER($)/GRANTOR($) - ' ; ':._• - 4 - -- s Ir; ;- - .. v. " - >. •;-_Kali Summerville
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
643 N Busch Court
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
City,State,and ZIP Code City,State,and ZIP Code
812-632-0926
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 comp ete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Sinnatur of Seller Signature of Seller
Kodi Summerville Of/3V/2 Pi 7
Printed Name of Seller Sian Date(MMDOM11) Printed Name of Seller Sian Date(MM/00/YYYY)
F..BUYERCSIAGRANTEEQ 7.APPLICATION:FOR:PROPERT,Y:TAX DEDUCTIONS"IDENTIFY.ALL9 T/ JY= ..•q- --
_Jesse M. Straw p
Buyer]-.fame as op a vryance document - Buyer 2-Name as appears on conveyance ocu - A fr
venue �)
Address(Number and Street) Address(Number and Street) MAY I 2019
•
Princeton, Indiana 47670
City,State, Code City,State,and ZIP Code - iliouL_vgifyi
812-63535-9162
9162
Telephone Number E-mail Telephone Number E-mailCIBSON (.OLINTV nV�
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONSdCOcoNDITtoNb
Y. IDENTIFY ALL OF TH ITOKYES NO CONDITION1.Will this property be the buyer's primary IZI I-1 3 Homestead
residence? Provide complete address of primary ❑ IA 4.Solar Energy-Hating/Cooling System
residence,including county: ❑ ❑
S.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
I7 ❑ 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 ❑ 2 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.
634 N. Busch Corut Not available in all counties]
Address(Number and Street) ^'''�) •'�'j � (�'�1U'
Princeton. Indiana 47670 Gibson Ob ell-12%. -oa -0o _l • 7 a —O2-2
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:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being iled.)
T- X sw----
Signature of Bayed Signature of Buyer2/Spouse
Jesse M Straw / 3� ���
Printed Legal Name of Buyer I Sign ate(M /DD/YYYt) Printed Legal.Name of Buyer 2/Spouse Sign Date(MM/DD/YYYY]
Last 5 digits af Buyer l Driver's State Last 5 Digits cif Social Security Number Last S digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security
License/ID/Other Number Number License/ID/Other Number