HomeMy WebLinkAboutHomestead_RichterINDIANA SALES DISCLOSURE FORD1 SDF ID: Page 2
D.PREPARER
J. Robert Kinkle
Preparer a%rhe Sales D'udosure Form
279 N. Hart St. PO Box 13
'ress (Number and Sb'ee[J
., ceton IN 47670
Ciry, Smte. and ZIP Code
i.
Seller ]- Rome ns nppears on ronve��ance dacument
604 N Church Street
Addres (Number nnA 5beetJ
Fnrt 8ranrh IN 47R4R
Cinc Smte, and ZlP Code
�/
Title
Hail, Partenheimer & Kinkle
Compony
E-mail
Seller Z- Name as appears on conve�nnre docvment
Address (Number ond Sneet)
Ciry. Smte. anAZIP Code
Under penalties of perjury, 1 hereby certify [ha[ this Sales Disclosure, to the best of my knowiedge 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".
X��iL/ir� l"�' T—/���
�Signamre of5eller Signa[ure of5eller
FOR PROPER7'Y
Buver I- Name as appears on cc
.4ddress (h'umber md SlreetJ
'�ubstadi. IN 47639
,
E-moil � TelephoneNumber
THE SdLES DISCIASURE FORM A1A1' PF. USED TO APPLY FOR CERTAI.Y DEDUCf10N5 FOR THIS PROPERTY. I DE4TIFY ALL OF THOSE THAT APPLY.
Q � 1. Will this property be the buyer's primary
residence? Provide complete address of p�ima�y
residence, induding county:
dddres (A'umber and StreetJ
Fort Branch IN 47648 Gibson
Cipt Sm�e Z(P Code Counry
�� 2. Does the buyer have a homes[ead in Indiana to be
vacaced for this residence? If yes, provide
complete address oFresidence being vacated,
including munty:
Address (Numbe� and Sveer)
Ci% Smte ZIP Code loun9�
YES
�
❑
❑
❑
�
❑
❑
NO
❑
❑✓
❑✓
�
�
❑�
❑✓
3. Homestead
4. Solar Energy Heating/Cooling System
5. Wind Power Device
6. Hydroelectric Po�ver Device
7. Geothermal Energy Heating/Cooling Device
8. Is this properry a residential rental property?
9. Would you like to receive tax statemenu for this
property via e-mail? (Provide contoct informotion
below. Please see instructions for more information.
Not availa6le in all coundes.)
��-�9-� S -� /oaa a � 8`oa �
nnifer M. Richter
name
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 Ac[". (Note:
Spouse information, Social Security and Driver's License/Other numbers are no[ necessary if no Homestead Deduction is
being filed.)
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londfcr AA R'rf tP� I I �� I ��
PnntedLegalNamen�Buverl SignOn[.(HA DD/1YYYJ PnnredLegalNameo/Buyer?/Spouse SignDare(MM/DD/VI'YY)
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Last 5 digiLS o(Buyer 1 Driver's Sm[e Las[ 5 Digits o%Social Securiry Num6er Last 5 digiGS o(Buyer7/Spouse Driver's Smte Last 5 Dlgiu of5acial Security
License/!D/O[herNum6er Number License/ID/O[herNum6er
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