Homestead_Holden (3) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Roman Ricker Partner
Preparer of the Sales Disclosure Form Title
219 N. Hart Street, PO Box 13 Partenheimer,Kinkle&Ricker
Address(Number and Street)
E-mail
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Sheila Templeton
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
3417 S 125 F
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670 /
E-mail Telephone Number E-mail
Under penalties of p..,jury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
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cd complete as re 1,fired by I , nd is pr pared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller I Signature of Seller
Fiheila Templeton 10/19/2020
Printed Name of Seller Sign Date(MM/DD/YYYYJ Printed Name of Seller Sign Date(MM/DD/YYYY)
P, BUY_MST/GRANTEE(S)•-7=;AP P LK ATKIN,:F 0:itTRQ P ERTY TAX D EOUGTI ONS 41--)ENTIU ALLITE ': T-If03:P_ .: . :--— .- '
Mason Shane Holden I ,
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyanc um
1490 N. 100 W.
Address(Number and Street) Address(Number and Street) U L I 2 i 2020
Princeton, IN 47670
City,State,and ZIP Code City,State,and ZIP Code .
Telephone Number E-mail Telephone Number C-IIRSON COUNTY AUDI I 1Jnaii
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
Z 0 1.Will this property be the buyer's primary IZ 0 3.Homestead
residence? Provide complete address of primary rj z 4.Solar Energy Heating/Cooling System
residence,including county:
0 Ei 5.Wind Power Device
3417 S. 125 E.
Address(Number and Street) 0 z 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson E z 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
E z 8.Is this property a residential rental property?
0 2.Does the buyer have a homestead in Indiana to be
Z
vacated for this residence? If yes,provide 0 111 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)
r2--C •— \2 --2_ck-14 00 - 00o, cq, 2 - orl.-i- .
City,State ZIP Code County
Primary property owner contact name E-mail
Number License/ID/Other Number