Homestead_Adamson (9)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
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�� J. Robert Kinkle Attomev at Law
PreparerofrheSalaDrsd�vreForm Title
219 N. Hart Street Hall. Partenheimer & Kinkle
Address(Numberand5tree[)
E�mail
E: SEti�ER 5 .GRANTOR S ��..�` : ...:���� _��, t?,4'-N?: ,xw. �,�r..4,�"�-Sa E�::��� w � �� r�'-: `«�`s _ '..�'".s�` . �� �'_. s dtr.;
.lonathan P. Adamson
Sellu 1� Name as appeors am m�veyvnce dorvmm[ Sd/er 2- Name os appsirs on conveyantt dorument
10583 S. 350 E.
Addrm (Numbvand Street) Addrat (Number and StrcetJ
Haubstadt. IN 47639
mail Tde honeNumber E-mail
Under penalties of perjury, I hereby cercify tha[ this Sales Disclosure, to [he best of my knowledge and belief, is true, correc[
an comp ete asd e ired by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act".
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:F: B S GRANTEE ."APPLtCAT10N+FOR P.ROPERTY,TAX DEDUCTIONS �IDENTIFYAGL{ITEMS:THATAPPtiY�?'� ��-.3 3�0. -' g_j-�
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40 Im Street
ACdrm (Nom6aand Stree[) Address (NUmber ond Sb-vet)
aubstadt. IN 47639
Td hweNumber E-mail
THESALESDISdO51IREFORMMAYBEUSEDTOAPPLYFONCERTAIYDEDULTIONSFORTHISPROPER FYALLOFTNOSETHATAPPLY.
YFS NO CO\DITION 5'FS NO CONDITIO,�'
Q� 1. Will this property be the buyer's primary � ❑ 3. Homestead
residence? Provide complete address of primary � . o ar Energy Hea[ing/Cooling System
residence, induding county:
��SA3 S s�n E ❑ Q 5. Wind Power Device
AdEr¢s(NumbrrandSbretJ ❑ ❑ 6. Hydroelectric Power Device
Haubstadt IN 47639 Gibson � Q 7, Geothermal Energy Heating/Cooling Device
Ciry.SmteLPCOde Counry
�✓ � 2. Does [he buyer have a homestead in Indiana to be � ❑`� 8� �s this proper[y a residential rental property?
vacated for this residence? If yes, provide ❑ ❑� 9• Would you like to receive [ax statements for this
complete address of residence being vacated, property via e-mail? (Provide mnmct information
including county: 6elow. Please see instructions for mare informadon.
404 B West Etm Street Not availa6le in all countles.J
Addrm' (Nvmber and Street)
Haubstadt, IN 47639 Gibson ��;3 -03-o�f.b- t�a. i.3 �-oa �
Ciry, Smte LPCOde Counry
Rima77�FertYOwnrrconmRname E-mail
Under penalties of perjury, l hereby cerufy that this Sales Disclosure, to the best of my knowledge and belief, is true, corred
and complete as required by law, and is prepared in accordance with IC 6-11-5.5, "Real Proper[y Sales Disclosure Act". [Note:
Spouse information, Social Security and Driver's License/Other uumbers are not necessary if no Homestead Deduction is
bei�ed.)
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Signumre of Buyvll SignoNre oJBuya2/Spouse
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Num6er Lirense/ID/OtherNumber