Homestead_Miller (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
.:•-tii-PREPAII-til7:: -7''.-7: :7-'-':;=l':,:' ---::'T':-'..;-• -:-.7.---_ 77:,- .::.7 27'--; '-':_ ''''''-:-'.'-' ,'''-7- :`.--,7,;.:777-:-. r-I''-'77,,-7.,7.7''"7:-'..7-', —1-: ",=,..:',-r'T:,;,--,`
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Title
219 N. Hart Street Partenheimer, Kinkle&Ricker
Address(Number and Street) Company
Princeton, IN 47670
E-mail
Ellis Estates, LLC
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
12112 Petersburg Road
Address(Number and Street) Address(Number and Street)
Evansville, IN 47725
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".
- --,--'.--
Signature of Seller Signature ofSeller
Brian Ellis Managing Member 1/31/2020 _ i - - •
Printed Name ofSeller gn Date(MWDDJYYYYL Printed Name of Seller 1 I
ign Date(MMIDD/YYYYL_
:.F- , ' , '• " TE S:' .APPL-ItATION'POR.PROPtItstVIA-13Ebt1t1TON'S'÷:,I b8SNIPY' ELIE 5,31ilt,,, ! I,:",,':::":,____:1.1_;_s:.L„____:_.:._,r.ii.
Ellen Marie Miller
Buyer 1-Name as appears o conveyance document Buyer 2-Name as appears on converEl3loc5ment2020
woo w
Address(Number and Street) Address(Number and Street)
• 1 -.iv
Owensville, IN 47665 st.,,, —4,11111,
City,State,and ZIP Code City,State,and ZIP Code
GIBSON COUNTY AUDITOR
APPLY FOR CERTAIN DEDUCTIONS FORT ROPERTY.IDENTIFY ALL OF THO THAT APPLY.
YES NO CONDITION YES NO CONDITION
IZI 0 1.Will this property be the buyer's primary Z 0 3.Homestead
residence? Provide complete address of primary ITh—ift q.auffri, eating/Cooling System
residence,including county:
D Z 5.Wind Power Device
105 S Church Street
Address(Number and Street) El EZ 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson D z 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El El 8.Is this property a residential rental property?
0 Z 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 0 D 9.Would ou like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Providecgjact information
including county: below.Please see instructions for m ormation.
Not available in all counties.)
Address(Number and Street)
Gibson 6 -li-I--2._-iso 1 --Oo 0, it 1- 6
City,State ZIP Code Coun
imary property owner contact name E-mail
Number License/ID/Other Number
1