Homestead_Lashbrook (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Jason Spindler _ Attorney
Prcpurer of the Sales Disclosure Form Yale
112 N. Main Street Spindler Law
Address(Number and Street)
r:lrv,State,and ZIP Cade Telephone Number Email
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E:SELL�EK�?���A�jrD:It(fi�� � , tt ;;,;; -...Q.!�.� ..•, h�:•Ptx,�:f4. ���, r :,..�' •
Estate of Daniel Lashbrook by Persona) Representative,Nikki iiimsdl
Seller I•Name as appears on conveyance document Seiler 2•Nrnne as appears on conveyance document
4185 West 180 North
Address(Number and Street) Address(Number and Street)
Jasper, IN 47546
City,State,and VP Code City,.State,and ZIP Code
Tcicpinau•Number i:•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,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
Sig ature of Seller Signature ofSellar
Nikki 1-limsel 10/03/2019
,t'etbNrant-of Sellcc____ ;..,,,___._....,..,...--:--•--,.-. Sign Date t vril/DD/Y1'1'YI Pouted Name of Seller Sign Date(+ut/an/rr YI
F;`6U1 Rtg R 1T i P�L CA `ro o PROPERTYTAXDED:aI Tf .NS`I]tiEN`TIET'.AliiiI :ElGi vtA 91•' 1�Y" : i " _
Timothy Lashbrook Renee Lashbrook
!laver 1•Nate as a ra rnva' ce do Witten t !Myer 2•Name as appears an conveyance document
30 East Wood Street 307 Rasa Wnod_Street
Address(Number and Street) rlddte.ss(Number and Street)
Francisco, IN 47649 Francisco, IN 47649
Cir,..State,and VP Oak My,State,and ZIP Cade
li•mail Telephone Number Email
TNESt1LES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTMN DEDUCI•IONS FOR THIS PROPERI'l'Y. IDENTIFY ALL OF.r11osETHAT APPLY.
YES NO CONDI'rUON Yl:ti NO I'r
•
Er ❑ 1.Will this property be the buyer's primary X 2 3. Homestead
residence? Provide complete address of primary p eating/CFD i '
residence,including county: ❑ 5.Wind Power Device
309 E.Wood St. Oct 07 2019
Address(Number and Street) ❑ Q 6. Hydroelectric Power De e
.
Francisco, IN 47649 Gibson ' 7. Geothermal Energy Hui/ i❑ j Device
Clrv,Stare ZIP Code County
[v�' ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 2 8. Is this property a JfelliAaltcDl•�ti iNAT B
vacated for this residence? If yes,provide ❑ Q 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: o>,vr ease e'i-nst-r lions for more information.
307 East Wood Street Not available in afl counties,
mdross(number(7m!Slreet)
Francisco, IN 47649 Gibson 26-13-20-101-000.060-005
City,State ZIP Code County