Homestead_DillINDIANA SALES
Kimberly A. Lewis
Preparero/[he Salc D'uclosure Form
and5tree[)
Office Manager
Title
Broadwav Titie, Inc.
Compaq
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Prin�atnn� TN d7F7(1
StenhPn R. Banet
Shcer 1- Name aa opptars on conveyance doaumrne
200 Madison Falls Ct.
Address (h'vmber and StreetJ
Linda K. HPldt
SA/rr 2- Name as appeon on conveyance docvmmt
5526 Blackhawk Ct.
Addrecs (A'vmbe( and Stree[)
Columbus, IN 47201
nJ/x
Under penal[ies of perjury, I hereby certi(y [hat [his Sales Disdosure, to [he bes[ of my knowledge and belief, is tn
an �,p mple[ as required by law, and is prepared in accordance w�i[� JC 6-1.1-5.5, "Real Property Sales Disclosure
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PROPERTI'. IDENTIFY ALL OF THOSE THAT APPLY.
�] ❑ 1.1Vill this property bz the buyer's primary
residence? Provide comple[e address of primary
residence, induding county:
2235 W 100 S
Add�ess(NumberanOStreeQ
Princeton, IN 47670 Gibson
Ciry, Smce ZIPCode Counry
[� ❑ 2. Does che buyer have a homestead in Indiana to be
vaca[ed for this residence? If yes, provide
complece address of residence being vacated,
includin county:
1909 Blvd. $lace
Addrctt (Nvmber andStree[)
—P.rinr.ptnn, T�� d���0 Gibson
Ciry.SmreZIPCade Counry
[n] ❑ 3. Homestead
❑ � 4. Solar Energy Heating/Cooling System
❑ � 5. Wind Power Device
❑ �'] 6. Hydroelectric Power Device
❑ � 7. Geo[hermal Energy Heabng/Cooling Device
❑ � 8. Is [his property a residential rental proper[y?
❑ � 9. Would you like to receive [ax sta[ements for this
property via e-mail? (Provide contoct information
6elow. Please see instrucfions%r more information.
Not available in all counties)
�I�y .3m-�S oa-7
NImONWVO[![YOwp¢�CVAtA[[!IOlIIC E�mall
Under penalties of perjury, I hereby certify [ha[ [his Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and complete as required b}• law, and is prepared in accordance �vi[h IC 64.1-S.S, "Real Property Sales Disdosure Ac[". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.) � ,• , �/ , � _ r,
Sign Da[e [MM/D�/vm7
LastSdigiao(Buyer]Driver's Smte LostSDigitsoJSocial5ecunryNumber
Licente/ID/Oth er Num6er
� RmA��A K. U� / l U�'/ds/a�O7
PnnredLegalNameofBuyerl/Spovse i&nDa.e�MN/DD/YYYF]
Las[ 5 digia o/Buyer2/Spouse Drive�'s Smte Last 5 Digia ojSacial5ecunry
A'umber License/1D/OrherNumber