Homestead_Dunn INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D PREPA&ER
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 (
E-mail
E SELLER'CS)YGRANTOR(S) _ . L_.�. .Lir.
_ .- ._ . _:Sc —__._ '_- ____ _.._w1 7 _---_— _'_7 ., _ :
James B. Blacklock Amy L Blacklock
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
7800 F SR 64 7800 F SR 64
Address(Number and Street) Address(Number and Street)
Francisco IN 47649 Francisco,IN 47649
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 s r it d y 1 w,and is prepared in accordance with if 6-1. 5.5,"Real Pr per ly Sales Disclosure Act".
�1 a/z�,-2dz9 er/ L1 6,
Signature of Seller Signatur Seller
James B Blacklock Amy L. Blacklock /--a4 avar)
Prin r Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
:_._BUYER(S)/GRA: EE(S)._._4PPLIGATION FOR PROPERTY TAXzD;ERUCTIo:Wi_DENTIFYc,ALL_ITEMS THAT AP PLY ___ ;':1'
Terry E. Dunn _ T.
Buyer 1-Name as ao on conveyance document Buyer 2-Name as appears on on ey ce ocum• . ,
518 S. Gibson Street
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660 JAN 2 8 2020
DEDUCTIONS FO -HS PROPERTY. IDENTIFY ALL OF TH �'' .xf AUDITOR
YES NO CONDITION YES NO CONDITIONISSO
❑ 1.Will this property be the buyer's primary ❑I 3.Homestead
residence? Provide complete address of primary ❑ _ eating/Cooling System
residence,including county:
518 S. Gibson Street ❑ 0 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Oakland City, IN 47660 Gibson ❑ 07.Geothermal Energy Heating/Cooling Device
a
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 ❑ IZI 9.W. , •.. •-- . -• -' e tax statements for this
complete address of residence being vacated, property via e-mail?(Provide . • .ct information
inclu.•;g cou : below.Please see instructions for mot- ' ormation.
• ;k r .01, y ' 3-1-- Not available in all counties.)
A es (Num er and Stree ^2 I m�^ 0 I 1 1 ^�fl ,
moo- I �740 . /0AC io o.0 13I I
City,State ZIP Code I aunty
ary property owner contact -mail `
Number License/ID/Other Number
