- Ortiz, Ernesto_7/25/2022 INDIANA SALES DISCLOSURE FORM SDF ID: 4 Page 2
D=�P,-REPARE.R _ _-� --, y'_�._ .�-'---_ ._ _...
Roman Ricker Partner
Preparer of the Sales Disclosure Form Title
219 N. Hart Street Partenheimer.Kinkle&Ricker
Address(Number and Street) amt., .
Princeton, Indiana 47670 E-mall
City•State,and ZIP Code
E;SEtiLER(S)/OMN:1 11kfs` .5 ,IT _ _::1.:Ifi• ...}.— .: x 1 4_. i.._..
Marilnuise Sinkhom Mariloiiise Sinkhnm
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2111 F I ake Road 9111 F I ake Road
Address(Number and Street) Address(Number and Street)
Princeton Indiana 47670 Princeton,Indiana 47670
E-mail
Under ,enalties of perjury, reby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and c- ,lete as requ- d law a is prepared in accordance withG� �"Real Property Salesr closure Act".
X4 •o ` / ignv[ureo�Seller wYNO
Sign•%ure of Seller
Marilo 'se Sinkhom by David L Sinkhom. POA 8/14/2020 Marilouise Sinkhorn by Lisa A Sinkhorn.POA 8/14/2020
Sipn Date(MM/DD/YYYY) Printed Name of Seller S(qn Date(MM/DD/YYYY)
Printed Name of Seller -_ - -�
,F:;BUYER(S)/,GRANT.EE.CS)t APPLICATLQN FQI P-ROPERT$TAX DEDUCTI.QNS `I�DENITIFY ALLI-TEMS THA`E-AP-1?LY_ _�._ .a: _-
Ernesto Ortiz Rosa Ortiz
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1905 Taylor Avenue1905d Taylor Avenue �y �
Address(Number and Street) Address(Number and Street)
Princeton, Indiana 47670 Princeton. Indiana 47670 L -J
Ci State and ZIP Code City,State,and ZIP Code
812-664-0678 AUG7 2020
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 YES NO CONDITION Orts
WI ❑ 1.Will this property be the buyer's primary 0 El 3.HomestellBSON COUNTY AUDITOR
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0 S.Wind Power Device
• 2111 F I pki Read ❑ 6.Hydroelectric Power Device
Address(Number and Street)
Princeton,Indiana 47670 Gibson ❑ g 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County D 0 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be El El 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide property via e-mail?(Provide contact information
complete address of residence being vacated, below.Please see instructions for more information.
j including��1 nn���yyn �'1 /'1� Not available in all counties.)
1905 Taylor Avenue }� r of Of
Address(Number and Street) —f — (2-0 11—11 Q 2. —O m it [t 1,--_ p Zr7
Princeton,Indiana 47670 Gibson Lb y L c� C
County E-mail
City,State ZIP Code Primary property owner contact name
•
1
I
i
1
I
l
S
1