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Homestead_PottsINDIA\A S:�LES DISCLOSIJRE FOR�I SDF ID 26-2009-1000664 ' 1 Pa�e 2
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J. ROBERT KINKLE HALL PARTENHEIMER 8 KINKLE
N. HART ST., PO BOX 13
PRINCETON, IN 47670
Circ Sioie. m�J ZlP Qxit
3. SELLER(S)/GR.4NTOR(S) „ . .
ALAN M. WOLF
Sr/!rr - A'nmr ns rrpreurs on romn'nncr Jo.vmtm
307 E. PARK STREET
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FORT BR4NCH, IN 47648 � 1
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ATTORNEY �
HALL PARTENHEIMER 8 KINKLE
TefrphuceS'umAer f-rnui!
Sel/rr -�'enre as opptmrs a� rnnst+'once dorum.vn
AAJress (:\'enn6rr or.d Svr;i
Cin'. Stntr. ond Z/P Co-fe
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Jnder pen:dtie � f perjun�, I hereb}• cer[if�� that this Sales Disclosure, m the betit of my kno�sledge and belief, is true, correct and
�.omple[e as r uired b�• la�s, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Propert}• Sales Disclosure AcP'.
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APPLICATIO\ FOR
E-mrd/
'HF $,1I.FS DISCLOSORF FOR�1 �IAI' BE USFD TO APPLY FOR C� 2TAL'
� I. U'ill this propem be [hc buyei's primary re;idence? Provid com e[e
address of priman• residcncc. includin_ count}•:
307 E. PARK STREET
Addrcss f:�'��nrMr nnd Aree�)
FORT BRANCH, IN 47648 Gibson
C:p. Sia;e. nnJLPC«k Cmmn�
r?. Does the buyer hace a homestzad to be aacated for thi: residence? If
yes, provide complrce address o(rrsidenez vacatine. including county:
100recv /:4vmhvrcnJSr�retJ
CIn�. Sm:r. nmlTJPCMr Cbunrv
Ainlyd 1'mne af5r/ttr Sign Da+e I.ILIODD/1'f')]7
- IDE\TIFY ALL ITED4S THAT APPLI'
MARY N. POTTS
Bv� rr -:Vnmr at �m� ... nn mmrrnncr Ja.vmcc/
. GIBSON STREET, APT. A
AAJress (:4Ynnber onASrreet)
HAUBSTADT, IN 47639
Cin'. Smtr. and ZlY CoJe
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)UCTIO\5 POR l
� 3. Homatead
r 4 Solar e�tingiCooline System
r 5. R'ind Po«•er Decice
r 6. Hydroelectric Power Devict
r 7. Geothennal Enzrg}' Heatine/Cooling Device
r R. Is this property a residential rental property'?
j— 9. R'ould }'ou like to recicve taz statements for this propem� via
c-mail.' /Prm�ide cnmacr infonnaiion helm+�. Ple¢se see rhe
irzvinrcliun..- ibr more inl��nnntiorr. �br m'ailab/e irr al/ co�mtieaJ
�!o-19�1� �3o1-c�c .ti69-
Primon� p�oprm• orcne� rornon namr B
Under penaltles o� pequry. � nereo�• cernt} mat mis aa�es viscrosure, m me oes� o� m�� �:no.� icugr anu ueue�. u�� �r, �o� � r« a��� �o�
required b}• la���, and is prepared in accordance with IC 6-I.IS.i, "Real Property Sales Disclomre AcP'. (�ote: Spouse Information,
and Driver's Licenseluther numbers are not necessarc if no Homestead Deduction i�bein� fil�d.�
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