Homestead_Lance (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
-D..PI2EPARER411_ - g .c+a '--r. 'st i- .. :.Svrizi..-2_ . 72117z- ._L, ry v.i '7::-3 .a nLy.—. .I
James G. McDonald, Ill Attorney at Law
Preparer of the Sales Disclosure Form Title
120 S. Main McDonald Law Office
Address(Number and Street) Company
Princeton, IN 47670 (
E-mail
E^SELCER(S)/GRANTOR(Sj St !°b.ts.: F 1L• : • .t,y tf 4wz a Y[ 1' tl. a[t)'_ik YlK Ac It iNs:ice_
The Estate of Paul Dean Henson The Estate of Paul Dean Henson
Seller 1-Name asappearson conveyance document Seller 2-Name as appears on conveyance document
9600 Echo I ane 907 Rirkshire Ave
Address(Number and Street) Address(Number and Street)
St Louis MO 63114 Chandler IN 47610
City,State,and ZIP Code City,State,and ZIP Code
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 req a bylaw,and is prepared in accordance with IC 6- .11-5.5,"Real PrQpe leDi closure Act".
tSi:atareofSeller i`!I llX _ gnatureofSeller L /,C'—)
K Doyle Unsupervised Co-Personal Rep O 1 '- i 9 Thomas E Roach Jr Unsuo Co-Personal Reo 8/16/2019
Pr' o(3ertec (Sian Date(MM/OD/rPm3 Printed Name of Seller Sian Date(M14/DD/YYYY1
..BUYER(S)/GRAN. E(S)_-,AP.PLICATION.FORPROPERTYTAX.DEDUCTIONSIDENT - . !E I PLt? - _ -I
Kathy Lance - JII�rLLJtJ
vet I-Name as rs on conveyance document Buyer 2-Name as appears on conveyance document
315 W.Columbia Street AUG 21 2019
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIN PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES fits CONDITION
Z ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary 4 Solac Eu eating/Cooling System
residence,including county:
123 W Elm St ❑ 0 5.Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Oakland City, IN 47660 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
M ❑ 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 ❑ ❑ 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: s . tease see instruction re information.
Not available in all counties.)
315 W.Columbia Street
Address(Number and Street)
Oakland City, IN 47660 GibsonC
6-14 - C 8 -304- 001 -20$- p pi-
Cig.,State ZIP Code CountyOproperty owner contact name E-mq/I
Number License/ID/Other Number