Homestead_Campbell II (2) INDIANA SALES DISCLOSURE FORM SDF ID: 26 - 19 1131071 Page 2
D.PREPARER -
CARLA WALTMAN ESCROW CLOSER
Paperer of the Sales Disclosure Farm mile
331 FRANKLIN ST TITLE CENTER OF INDIANA
Address(Number and Street)
E.SELLERIS)/GRANTOR(S)
RONALD C CAMPBELL PATRICIA A CAMPBELL
Seller I.Name as appears on conveyance document Seller 1-Name as appears on conveyance document
3993 W 200 S 3993 W 200 S
Address(Number and Street) Address(Number and Street)
OWENSVILLE, IN 47665 OWENSVILLE,IN 47665
City,State,and ZIP
E-mail
Under p tallies of 'or ,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,co : •t
fp> p e 1s qu' -e by law,and is prepared In accordance Ith•I .6•\.1.5.5,"Real P•. et y-!ales Disclose ct".
7 /j , t—
/ ,1'(linutur.of Seller .Sip wore of:fir WIIIIII.'MI 'I ISre "\ is
RONALD C C E� 13°'ll PATRICIA A CAMPBELL A 7xl,
Print acne at Setter Sian Date 1.01/DO/M11 Printer!Mime of idler Sion Dote(Airport r n
p ,F.� YER(S)fGRANTEE(S)-APPLICATIOP __.FORPROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY. _ ._ _
e/RONALD CLAYTON CAMPBELL II MEGAN RAE CAMPBELL -
l( Buyer l- move ncr. • t Buyer 2-Name as appears on conveyance document
�9998-W ttro 3993 W 200 S
Address(Number and Street) Address(Number and Street)
OWENSVILLE,IN 47665 OWENSVILLE, IN 47665
City.State,and 7dP Cade
V E.mall
cp032019
TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FORT IIS ROPEIltY. IDENTIFY ALL OPtTtOS IIAT APPLY.
YES _ NO CONOITIDN YES NO CONDITION
m ❑ 1.Will this property be the buyer's primary ❑ 0 3.Homestead GIgSON COUNTY AUDITOR CB
residence? Provide complete address ofpri ary D___JA__4-SalacG+aergy{i eating/Cooling System
residence,including county: l\
3993 W 200 S `-wind Power Device
LlrlpsHstmbcrandstrcet ❑ m 6.Hydroelectric Power Device
OWENSJILLE, IN 476I65 26
0 m 7.Geothermal Energy Heating/Cooling Device
City,Stara ZIP Code County
❑ El 2.Does the buyer have a homestead In Indiana to be 0 ® B.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ m 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.
SPLIT `(a Not7 available in all counties.)
Address(Number and Street) /I-21 — 3.30" (�00s ( 0 `7
^o s +-
RONALD CLAYTON CAMPBELL II
City,State ZIPCade County
Primary property owner contort name E-mail