HomeMy WebLinkAboutHomestead_Kay INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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D:rPREPARER� t i_.,-_ LC ..—_n.. 'ail 3ttT 2, _-_?;vh..r°i� S _n _� - P,_ I ::'
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)
E-mail
E.SELLER(S)/GRANTOR(Sj �;_'•. a .._Ti•_- _ . '--_s1:4 ._.„-'s t3:1"4 .!re -r,{_. `._2Th _...z- ----;-71,.F 1117a.
The Estate of Henry MaII9ard ,Ir
Seller 1-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
539 W 650 S
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648
t p
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 required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Sandra 1 Hicks (Incur) Pets Reo 5/9/2019
Printed Nome of Seller Sian Date rM.Mfaa/YYn) Printed Name olSeller Sian Dater M rv1)/oo/Y
F.:BUYER(5)I_c_RANTEE(S)1±APPEICATIONIEOR PROPERTY,TAXrDEDUCTI0NVIDENTIFY,ALL IITEEMSgITHAT��`, ' A• 4 _ _ Li___.
Andrew R. Kay
Buyer l-Nv " anveyance document Buyer 2-Name as appears an c veyan d
1300 . baint dames Blvd.
Address(Number and Street) Address(Number and Street) 1 1 3 2019
Evansville. IN 47711 MAY I
City,State,and ZIP Code City,State,and ZIPCode /1
E-mail Telephone Number CCCr��qq ���((�1��t�t{��ITY AUDITOR E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P ALL�'RIOSE'IHXfAPPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1.1Nill this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary 4.SOIar Energy Heating/Cooling System
residence,including county:
612E 1025 S ❑ M 5.Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt. IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City State CadeLi County
M [ 2.Does the buyer have a homestead in Indiana to be (II ❑✓ 8. Is this property a residential rental property?
�wacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, contact information
including county: below. Please see instructions forma motion.
1+ Not available in all counties.)
Add r ss(Numbeian dSti_tt) drew.E CI 3 Z_1 O ( _O V 0 - 6)d^O Z
Cry;Slate ZlPCode--j C� oanry� y
�LJ Prim rN owner conALm17177R
Number License/ID/Other Number