Homestead_Averette Jr INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Roman Ricker Partner
Preparer of the Sales Disclosure Form Title
219 N Hart Street, PO Box 13 Partenheimer, Kinkle& Ricker
Address(Number and Street) Company
Princeton, Indiana 47670
E-mail
E.SELLER(S)/GRANTOR(S)
Cassie M.Wallace k/n/a Cassie M. Hicks
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
529 S.Stormont Street
Address(Number and Street) Address(Number and Street)
Princeton, Indiana 47670
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 of Seller
r,assie M.Wallace k/n/a CassieJ,ll. Hicks 6/19/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F.BUYER(S GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY'ALL risi "P T P(LY
Phillip I Averette.Jr I'1_�
- onveyance document Buyer 2-Name as appears on conveyance document
2150 Fosters Way.Apt 10 JUN 2 3 2020
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 Q
City,State,and ZIP
�' GIBSON COUNTY A.'JD!TOR
Telephone Number 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 I YES 0 CONDITION
❑ 1.Will this property be the buyer's primary , 0 ❑ 3.Homestea
residence? Provide complete address of primary ❑ 2 4.Solar Energy Heating/Cooling System
residence,including county:
529 S. Stormont Street ❑ ❑✓ 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 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 ❑ ❑ 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)
City,StateZIPCode County i4� `ot 07 - 79 y—�0`3..3 7 8-C�'l;s
Primary property owner contact name E-mail
Number License//D/Other Number