Homestead_Holden�.� �
INDIANA SALES DISCLOSURE FORM SDF ID: 1' Pa e 2
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Kimberly A. Lewis Office Manager
Preparero(rhe Svlc DBdosurc Form TiGe
2� W'-BLOadwdV- RrnaAwav Titln� jRC
Addrexs(NUmberandSCee[) Company '
Princeton, IN 47670
%E�SEL'�ER S-,GFL'4NTOR S;�..n r�:'�,��t`��.¢3?�vs����F3,?�v�°"`a r3S�Fti=��i"�Y 3i��yf�°c��"��k:-k`����;;°.�, -�r
Li erty Catt Brown
Seller ]- Name os appears on [nnveynnre Oavment Seller Z- Name as appears om m�ve}nnre daummt
5504 S. Salida St.
Addrus (Number and Stree[) Addres (Numbe� ondStreetJ
Aurora CA 80015
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Te/rohoneNvmber E�moil Tefe haneNumbu E�mall
Under penalties of perjury, 1 hereby certi(y that this Sales Disclosure, [o the best of my knowledge and belief, is true, torrect
and comp4� as r quir�d by law, d is prepare in accordance with IC 6-1.1-S.S, "Real Property Sales Disdosure Act".
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Sig r' e fSelle� SignaNreo/Seller
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PnnledA'ameofSe er SianDate MM 0� PtlntMNameo Seller Si nDare1MM/DD
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=FjBUY ; ��.EE S "-�`A .PGICi1 . �.. !PROP.ER'[�'eTAXIDEDUGTIONSjIDENTIF,YEAI:L' IT:fi�iS;THAT�AP.P,ISYrv �W;�:`��'�.'s`'.� -�
Matthew L. Holden Rebek�h J. Holden
Bvyrll�Nameasappeorso ument Buyer2�Nameasappearson�onveyancedocumml
W. Boonville New Harmony Rd. 9900 W. Boonville New Harmony Rd.
Addrm (NUmberond Street) Addrat (Nvmber and Stree[)
Evansville IN 47720 Evansville �N 47770
�Ciry.S[o[g and ZIPCode
THESALFSDISCLOSUREFORMAfAYBEU5EDT0APPLYFORCERTAI.YDEDUCfI01SFORTHISPROPE OSETHATAPPL7'.
YES NO [OVD1T10N I NO COYDITI ,
Q � 1. 4Vi11 �his property be the buyer's primary [� ❑ 3. Homes[ead
residence? Provide complete address of primary { 4. Solar Energy Heating/Cooling System
residence including county:
1550 N. 100 N�est ❑ � S.WindPowerDevice
PT1nce�ontreP�IN 47670 Gibson ❑ � 6.HydroelectricPowerDevice
❑ � 7. Geothermal Energy Heating/Cooling Device
Ciry, Sm[e ZIPCode Covnry
� � 2. Does the buyer have a homestead in Indiana to be � � $• Is this property a residen[ial rental property?
vaca[ed for this residence? IFyes, provide ❑ � 9. Would you like to reteive [a�c statements for [his
comple[e address of residence being vaca[ed, property via e-mail? (Provide contacf informotion
including county: below. Please see instructions%r more in%rmation.
Not availa6le in all counnes.)
Addren (h'vmber ond Street)
al�-o'�-�3�-ti�-c� .i��-oa
Ciry. State ZIPCode Counry
Pn'maryproperryowne�ron[uc[name Email
Under penalties of perjury, 1 hereby cer[ify [hat [his Sales Disclosure, [o the best of my knowledge and belief, is true, correct
and comple[e as required by la�v, and is prepared in accordance �vi[h IC 6-11-5.5, "Real Proper[y Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.] _
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Social5ecuriryNumber Las[SdigirsojBuyer2/SpauseDriver's Smte LastSDigicso/Social5ecunry
License/ID/OtherNum6er Number Lirense/(D/OtherNum6er