Homestead_Stevens INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D. PREPARER T' - -- , •'- ,' _. .,,-1`_` .H ._, _ - -='r °- —__. I
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Title
219 N. Hart St., PO Box 13 Partenheimer, Kinkle& Ricker
Address(Number and Street)
E-mail
E.SELIER�S)%GRANTOR(S)';,_ _ R. ::_ _'..'. " y.C ' i { s •-+
Kim S Glavich Maadcb ey/J
Seller I-Name as appears on conveyance document Seller 2-Name as appears an cone* document la e
1192 Pelton Road 1192 Pelton Road Vi\\C .
Address(Number and Street) Address(Number and Street) !Alit'
t oR
Fostoria OH 44830 Fostoria OH 44830 t�` • 411 NO
City,State,and ZIP Code
oNGo
Telephone Number E-mail Telephone Number Gies 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 complet equired by la v,and is prepared in accordance with IC 6-1.1- ,"Real Property Sales Disclosure Act".
Signature of Se ller b'f Signature of Seller
Kim S Glavich 8/7/2019 Mary L Glavich 8/7/7019
Printed Name of Seller Sion Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YM1
F. BU RANTEE(S) APPLICATION-FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THATAPPLY ' . . _ - j
John Stevens ale Stevens
Buyer 1-Name as - rs on conveyance document Bu}•er7 Name asa ...flan conveyance document
576 W.Julie Drive 2576 W. Julie Drive
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 Princeton. IN 47670
YES NO CONDITION I ,
(71 ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead-)
residence? Provide complete address of primary (,Ji 4. Solar Energy Heating/Cooling System
residence,including county:
5633 S SR 57 ❑ m s.Wind Power Device
Address(Number and Street) ❑ IA 6. Hydroelectric Power Device
Somerville, IN 47683 Gibson ❑ IZI 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
� ❑ 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 ❑ IZI 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.
2576 W.Julie Drive Not available in all counties.
Address(Number and Street)
Princeton, IN 47670 Gibson John&Gayle Stevens -2Q-11- 201-0a) . 509- QD1
City,State ZIP Code County
Primary property owner contact Fmrygd