Homestead_Gray (3) 1
INDIANASALES DISCLOSURE FORM SDF ID
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Chris Sullivan Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
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Princeton Presbyterian Church •
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
128 E State Street
•
Address(Number and Street) Address(Number and Street)
41'n /?Al 4'7a 70
state,and"IP code State,and Lit'uoae
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
Princet n Pre b erian Churc In�prporated 1
BY: k� � // A-t,e!, /� Signature ofSeller
N /'
Ron Whaley,President •� c — hs�tOcO
Printed Name of Seller Sign Datee�(MM/DD/YYYY) Printed Name of Seller j Sign Date(MM/DD/YYYY)
Wi . N EE(rSI AAl?t itrA IOIV F.ORiPR`OgERTY'PAktri IGTIONS5 Il)ENititA M itifigil gk'Iitikt AFAPLYA. ekitk- - e.`l
ared T.Gray Janice K. Gray
B rs on conveyance document Buyer 2-Name as appears on conveyance document
Morton Street 519 W Morton Street
Address(Number and Street) Address(Number and Street)
Oakland City,IN 47660 Oakland City,IN 47660
'. •. 1• ' ' • . 0 F THOSE THATIAPPLY.
YES NO. CONDITION YES 0 CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead i GIBBON COUNTY AUDITOR CB
• residence? Provide complete address of primary C - -;-,-- - ergy -eating/Cooling System
• residence,including county: ❑ Q 5.Wind Power Device
215 N Prince Street
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
'Print ton,IN 47670 Gibson ❑ Q :Geothermal Energy Heating/Cooling Device
city ate ZIP Code County ElIs this property a residential rental property?
❑. 2.Does the buyer have a homestead in Indiana to be ❑ Q 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
• proper ' - ' 7 ovide contact information
complete address of residence being vacated,
Ocliucrnounty: � e ow.Please see instructions re information.
�11 , ! "�' Not available in all count(es.)
ddrd ( umber an treet)k 1 •1 " , 26-12-O7'1O4-004. 4O6-028
� I� �(''���� ,�ty`'5\ \' T ared T.Gray Janice K. Gray--I�_
Iry,State IP Code �1 County Primary proper owner contact name E-mail