Homestead_CosbyINDIANA SALES DISCLOSURE FORM SDF ID: Paqe 2
D.PREPARER
J. Robert Ki!�kle
Preparera(the Salu Disclosvre Form
219 N. Hart St.. PO Box 13
� Addr�(Numberand5treet)
Title
_Ha_II, Partenheimer & Kinkle
fnmpany
E�mall
Alan G I innewa.her I Dana M. Linnewe6er
Seller ]� Name asappmrs om m�veyonce dotumen[ Seller 2� Name as appevrs am m�veyanre docvmen[
807 E_ Sinclair Straet 807 E_ Sinr.lair Streef
Addrea(Num6erord5treet) Address(Num6ero�Sbeet)
FoR Branch. IN 47648 Fort 8ranr.h. IN 47R48
Ciry. Smrc, ond
Under penaldes of perjury, l hereby cerdfy that this Sales Disclasure, to the best of my Irnowledge and belief, is true, correct
and complete asrequired.by la %and is prep/a/re'd in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Ac[".
L-c�LC��fi /.�/ �7�-vY.��'vW ��,, �,'�'�. rAti...�,= ..xi�.._�
SignatureajSeller �� SignoNreoJSeller
l�/� �� Dena M. Linneweber I I-a 1- II
- APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
John Michael Cosbv
Buyer 1- Nome as oppeurson ronveyanre dommenl
108 S. Race Street. Aof. A
Addres (Number a nd Street)
Haubstadt.IN 47639
THE SALFS DISCLOSURE FORM MAY BE USm TO APPLY
Chrisline M. Cosby
Buyer 2� Name as appevrs on ronveyanre document
108 S. Race Street. Aot. A
Addres (Number and Sneet)
Haubstadt. IN 47639
Ciry, Smte, and ZIP (ade
FOR THIS PROPERTY. IDEMI}Y ALL OF TNOSE THAT APPLY.
Q� 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
A07 E. Sinclair Street
Addres (Number ard 5[ratJ
Fort Branch.IN 47648 Gibson
City. Smle ZIP Lode Caunty
� ✓� 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? IFyes, provide
complete address of residence being vacated,
including counry:
Addres(Num6ero�d5tree[J � 1�
Ciry, Smte ZIP Cude Counq•
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3. Homestead
4. Solar Energy Hearing/Cooling System
S. Wind Power Devite
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is this property a residential rental property?
9. Would you like to receive tax statements for this
property via e-mail? (Provide ron[oct information
below. Please see instructions jor more information.
Not available in all counties.)
John Michael & Christine Cosby
E-moil
Under penaldes of perjury, l hereby cerUfy 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". [Note:
Spouse informadon, SociaLSecuriry and Drivers License/Other numbers are not necessary if no Homestead Deducdon is
filed.)
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LastS,d�gi[sofBuyer]Driver's Smte LastSDigiCSOJSociaiSecuriryNum6er
6icense/I D/Other Num6er
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Signamre of Bu}•er7/Spouse
C'hristine M(:nchy I 1 IZ� IZdI l
PrintedLegalNameojBuyer2/Spouse Sign le�M /DD/ml7
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LastSdigiCSO�Buyerl/SpouSeDriver's Smte LastSDigitsof5ocialSecuriry
Number License/ID/OtherNum6er