Homestead_Camden INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Leon C. Stone President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 (
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) _ . . . •
Kenneth V. Gamblin,Personal Representative for Linda J.Gamblin
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
115 N Jackson Street
Address(Number and Street) Address(Number and Street)
Oakland City IN 47660
.
Telephone Number 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 com le s r wired bxlaw,,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
`
Signature of Seller Signature of Seller
Kenneth V. Gamblin /-/ /7-d
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller _ " S n D (MM/DD/YYYY)
F.BUYER S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL IT ,S $ ,T H Al?lkil
l ••
ames C. Camden
_.Buyer 1-N,„•=svp arson conveyance document Buyer 2-Name as appears on conveyance doc 71 e,��VV f 0 7 2020
2692 S 1230E HH
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660apivi.
City,State,and ZIP Code City,State,and ZIP Code GIBBON COUNTY AUDITOR
(
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 NO eOi'WLTIQN
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ . o ar nergy Heating/Cooling System
residence,including county:
115 N. Jackson Street III ❑✓ 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
❑ z 2.Does the buyer have a homestead in Indiana to be El8 Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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 in all counties.)
Address(Number and Street)
014 -IV -a? - cm! of. L3 2 - O0l
City,State ZIP Code County
Primary property owner contact name E-mail
License/ID/Other Number