Homestead_Pancake INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER . . - - - - -
J. Robert Kinkle Attorney
Preparer of the Soles Disclosure Form Tide
219 N. Hart St., PO Box 13 Partenheimer, Kinkle& Ricker
Address(Number and Street)
E-mail
E.SELLER(S)/GRANTOR(S) - . - I
The Fstate of Paula J Eagan
Seller 1-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
_7051 E. 450 N.
Address(Number and Street) Address(Number and Street)
Francisco IN 47640
City,
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 required by law,anq is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Xkre oo-M1 �\.. d �����
Signature of Seller Signature of Seller I'-1
Shannel R Whitehead Unclip Pers Rep -ac -iq
Printed Name of Seller Sian Date MMM/DD/YTT/1 Printed Name of Seller Sian Date(MM/DD/YYYY)
PF:BUYER($JIGRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THSh'APPGYZOI9 ' - ' I
Draven M. Pancake) aC dv R n Pancake
-eryrn--dese-crawpw, on conveyance document Buyer 2-Name as appears an conveyance dace r� '
1077 Timberline Circle 1077 Timberline Circle GIBSON COUNTY
Address(Number and Street) Address(Number and Street)
Oak Grove, KY 42262 Oak Grove, KY 42262
City,
/
Telephone Number 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 YES__—NO--CONDLLQN
0 ❑ 1.Will this property be the buyer's primary / ❑ 3. Homesteac
residence? Provide complete address of primarJ. -0 Lir 4.Solar Energy Heating/Cooling System
residence,including county:
10343 S SR 57 ❑ ❑✓ 5,Wind Power Device
Address(Number and Street) ❑ g 6. Hydroelectric Power Device
Elberfeld, IN 47613 Gibson ❑ g 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ IL 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 ❑ Ii 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//l' in all counties.)
Address(Number and Street) �.4 - .20-3/ - c/ob - 000. / 49
-0 O/
Draven M.&Cady Renee Pancake
City.State ZIP Code County
Primary property owner contact name E-mail