Homestead_Monaghan II INDIANA SALES DISCLOSURE FORM SDP ID: Page 2
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Rexanne McCauley Title&Escrow Processing
Preparer of the Sales Disclosure Form Title
3930 Mezzanine Drive,Ste C Columbia Title, Inc.
Address(Number and Street) Company
Lafayette, IN 47905
�.
Norma R Gambrel
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
•
4532 Smyth Drive
Address(Number and Street) Address(Number and Street)
Fvansvilfe, IN 47715
City,State,and ZIP Code QV,State,and ZIP Code
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,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Sr ature of Seller Signature of Seller
Norma R. Gambrel 12/20/2019
Printed Name of Seller Stan Date(MM/DD/YYrI) Printed Name of Seller Sign Date(MM(DD/YYYY
70._ t l+> V. l..itat.Pl (littIMMT IUII_�r�'IONS___l bL I Y"7MT,EM `1I. "4PPJ.. � m
aniel P.Monaghan II
der I-Nameas.appearrohc document Buyer 2-Name as appears an conveyance dacunmeut
208 South Church Street
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665
B-mall Telephone Number Dec 26 2019 E-mail
THE SALES DISCLOSURE FORM MAY IiE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO 1:tt3ENTlF- THOSE THAT APPLY. •
YES No CONDITION YES NO CONDITION ]�
11 ❑ 1.Will this property be the buyer's primary [1 El3.Homestead GIBBON COUNTY AUDITOR CB
residence? Provide complete address of primary o a gy eating/Cooling System
residence,including county:
208 South Church Street ❑ ❑✓ 5.Wind Power Device
Address(Nuniber and Street) El 71 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ R1 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 ❑ IA 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: a ow.Please see instr or more information.
Not available in all counties.)
Address(Number and Street)
(26-17-12-201-000. 176-022
Number License/ID/Other Number