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INDIAP;A SALES DISCLOSURE FOR�1 SDF ID: Page Z
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D: YREP.ARER ; • .' • , ; : ;.:'_ . . . :�. . ., :• , - -
'Samantha Cutsinger
Preparer o/IM1e Sales Ditdomre Form T����
226 W. Broadwav Broadw� Titl� Tn�
Address (hbmDer ond Strce[) �°1^V°"1'
Princeton, IN 47670
Jac ueline R. McCo C'x.�r
Selier 1- Name os appmrs on ronveyonce document Seller 2- Name as appmrs on ronveyanae documrnt
5911 w. 200 N.
Addres (NumEer and Strret) Addrest (Num6er and Sneet)
Patoka, IN 47666
E-mml hle haneNumber E�moil
Under penalties of perjury, t hereby certify that this Sales Disclosure, to Ihe best of my knowledge and belie(, is [rue, correct
and complete a$ requi�d by law, and is pr�ared in accordance with IC 6-1.1•5.5, "Real Property Sales Disclosure Act".
David A. Lee
Buyer 1� Aame os apDmrs m mnveyanre doavmat
706 W. 6th St.
Address (NumDer and Stree[)
Mt. Carmel, IL 62863
Seller
Tina R. Hill
Buyer 2� Name os aOArors om m�veyance dovvmmt
706 w. 6th St.
Address (Num6er ond Sveet]
�It. Carmel, I� 62863
THE SAI.FS OISLLOSURE FORM AIAY BE USED TO APPLY FOR CERTAI\ DEDURIOYS FOR THIS PROPERTY. IDEKTIFY ALL OF TNOSE THAT APPLY.
� ❑ 1.4Vill this property be the buyer's primary
residence? Providecompleteaddressofprimary
residence, indu i county:
�R � ( �„� �.OD
Address(R'v� rand5tree,� � �� �I �
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Ciry, SNte2lPCode Counry
❑ I� 2. Does the buyer have a homestead to be vacated for
ihis residence? if yes, provide complete address of
residence vacaiing, induding county:
Addreu(NvmEerandSRee[)
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3. Homestead
4. Solar Energy Heating/Cooling System
S. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
6. Is this property a residential ren[al property?
o1G-O�` -3/- "�'�°-�aa<��/-�a�
Under penalties of perjury, t hereby certify that [his Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and omple[e a reqy� ired by law, and is prepared in accordance}v� h IC 6-1.1-5.5, "Real Prop erty Sales Disdosure Ac[".
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