HomeMy WebLinkAboutHomestead_Haines1\DI.\\.\SALESDISCLOSUREFOR�I SDFID SDOID 733040 Page2
D.PREPARGR �
Samantha Cuisinger
�Preparer oJahe 5cln Oisclosvrc form Dtle
226 W. Broativray Broadway Title, Inc.
Addrus(NumLeranASVreQ
E. SELLER S GRANTOR S
Timoihy K Stephens
Srller ]- Name ox appeors an �ome�vme Javment Seller 1� Nume as uppevrs on mmewnre dorvment
2124 W. 100 S
Address (Number and SverQ Addrrss (A'umber and Svett)
Princeton,IN 47670-
Ci9; Sm[t a�d ZIP Code Ciry, Smtc, nnd ZIPGade
Emuil Tele honeNumber E-mail
Under penaltles of perjury, I hereby certify [hat Ihis Sales Disdosure, [o [he best of my knowledge and belief, is true, correct
and complete s required by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act".
Sionnn,reofSelln - Signan..ra(seller
, k 03 � %'
, ,
F. BUYER 5 GRAN EE S APPLICATION�FOR PROPER TAX D NS-1DENTIFY MS�THATAPPLY
Ronald E Haines Teresa A Haines
Buyerl-M1'mnensap nronvevvn[edavmerr: Buyer2�NOmeasuppevrsan ynn[edxument
vans St.
dddms(Au andSVret) Address(�Yumbrrand5verr)
Pnnceton, IN 47670. Princeton, IN 47670.
Ciry.Smh. and ZIPCaAe
� E�moil
TNESdLESDI5CLO5UREFORMMAYBEU5EDT0APPLYFORCERTAI.YDEDU OILAIl4P80PERTV.IDENfIF1'ALLOiTHOSETH 1'.
YES `!0 COYDITION I Y'ES NO CONDITION
x❑ ❑ I. Will [his property be the buyer's pr ma ❑x ❑ 3. Homestead
residence? Provide comple[e addre of pn , aung/Cooling System
residence, including counry:
2�2a w i00 S ❑ Q 5. 6Vind Power Device
Mdnss(NUm.berand5tree[J � Q 6. Hydroelectric Power Device
Princeton, IN 47670 GIBSON � � 7. Geothermal F.nergy Heating/Cooling Device
Ciry. Smce ZIP CoOe Cavnry
� � 2. Does the buyer have a homestead in Indiana to be ❑ � 8. Is this property a residential rental proper[y?
vacated for chis residence? If yes, provide ❑ � 9. bVould you like to receive tax statemena for chis
complete address of residence being vacated, property via e-mail? (Provide conmct information
including county: befow. Pleose see instructions%r more in%rmatlon.
�'ot available in aU rountieS.J
AEdriss (A'umber ondSaret)
z= ��-//-i -/� -ceo. aG_ o� 7
Ciry.Smce ZIPCode [ounrv
Primary yinperry mma ror.mrt name E�mail
Under penal[ies o(perjury, I�hereby certify [hat this Sales Disdosure, [o the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Ac[". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
bei�n�g filed�.)� // /�� ,
i%v�,..,(il �' 7�cv.�. �l�' 1.Q�Q _�. L�-C�N.�a/
�Si namreofBUyerl Agnatureo/Bvyer2/Spoux
I�otikl.,Q E. �fw �ti �s 3-3�-1z Te�eSa C1� /-�cLnes 3-.3o-�a-
Fnn¢dLeyalNameufBU�eri S�qnDace�MM/ODM�'✓I P�n[edLrgaiRameofBuJ�erl/Syavsr SignDore�Nx/DU/YYYY�
�
SocialSecuriryNumber LostSdigiGSO/Buyer2/SpouseDriver's S[ete LastSDlgi6o/SonalSetunry
License/ID/Other,Yumber Number Lirense/lD/OtherNumber