Homestead_Madison (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
b PREPARER r k:-..;. i -_. . u1L 1.: U ' ,A _.Li_ Is -. _'_2- o,b- _•k i_ r•._ -:sL? _ _a
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Tide
219 N. Hart St., PO Box 13 Partenheimer, Kinkle& Ricker
Address(Number and Street) Company
Princeton, IN 47670
E-mail
E:SELER(S RAN T-O— S) +� Sii_a -__ vy' s—cvr x;ts_- r -.`r ,: a- ram:w ts -;PC;> :47r' ' '137
, —41
Habitat for Humanity of Gibson County Inc
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1302 W Rnimfield Avenue
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
City,State,and ZIP Code City,State,and ZIP Code
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 coin I lete as requg�ya nd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
eye Seller W Signature of Seller
Karen Beehtel President 7/25/2019
Printed Name of Seller Sian Date(MM/DD/YYY17 Printed Name of Seller Sian Date(MM/DD/YYY11
F: .Y-ER(S)7GFCANTE8 S)' APPLICATION'FORPROPERTY.:TAX DEDUCTIONSf IDENTIFYAl L1ITE.4 • 1AP - Y7 I-. •__ _ I...- •- j
Nathan A. Madison Amanda L. Madison H q M
BurrI nconveyance document Buyer Name as appears an conveyatlnedoc„ P4 AAA���"'
2464 W. 100 N. W. 100 N.
Address(Number and Street) Address(Number and Street) JUL 31 2019
Princeton, IN 47670 Princeton, IN 47670
City,State,and ZIP Code
AUNTY AUDITOR E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. ID I ALL OF THOSE THAT APPLY.
YES NO CONDITION I NO CONDITION
0 ❑ 1.Will this property be the buyer's primary P z ❑ 3. Homestead
residence? Provide complete address of primary , - - _• ,
.. •'' ring/Cooling System
residence,including county:
138 S Madison Street ■ FA" . ' ne 'ower Device
Address(Number and Street) ❑ 1z 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ Q 7. Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
❑ 0 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 ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, pro pro e
aitfif�" most information
information
including county: Blow. Please see instructions for mor motion.
Not available in all counties.) /7
Address(Number and Street) r`Z— l0 g r 3Q\ — 0 b y • 3° \_O2(8 ,
than A.&Amanda L.Madison 1
City,State ZIP Code County
Prima owner contact name -mail