Homestead_Howell INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - . ,
Leon C. Stone President _
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title. Inc.
Address(Number and Street)
E-mail
E.SELLER(S)/GRANTOR(S)
James W Hancock III Kathy W Hancock
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
306 West Vine Street 306 West Vine Street
Address(Number and Street) Address(Number and Street)
Fort Branch IN 47648 Fort Branch IN 47648
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 requir by law,and is prepared in accordance with IC 6-1.1.5.5,"Real Property Sales Disclosure Act".
Li) QY/ l }�A ).e, AL rLr S
nature of Seller Signature of See
JamesW Hancock III 7-,(0-/? Kathy Hancock —;'- ,• - /q
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller yjT VShilii(HM/DD/rvn7
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL IT j1 TAP-L, , 1
eresa S. Howell
on conveyance
document
Buyer 2-Name as appears on conveyance docUbf�[ 2.9 2019
1031 op lac �('\-
JUL
Address Number and Street) Address(Number and Street)
I'M- Cannel , I L I,ag(,3 //���' rA"
E-mail Telephone Number 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 �_YESN0 LONOITtO.N_
0 ❑ 1.Will this property be the buyer's primary \/ Q ❑ 3.Homestead
residence? Provide complete address of primary =-EZIj 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0
S.Wind Power Device
306 West Vine Street
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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)
a& —18 -/3 -'fO 3 . 000 • a d 7 -0)6
City.State ZIP Code County
Primary property owner contact name E-mail
Number License/ID/Other Number