Homestead_Lloyd,SALES
�
Dan L. Reeves
Preparer o(rhe Salu Disdosure Farm
1 � S. Main Street
a(Numberand Sveer)
�� ceton IN 47670
Ciry. Smre. and 2/P Code
E.
Seller 1- Name as oppears nn ronve}�ance document
Address (A'um6er and Stree[J
SDFID:
o' � Itd 47670
_ E�mail
rltle
Ilp��
n
Company
E-mail
Selfer 2- Name os appean on conve}vnce documm�
Address (Number ond Svee[J
Ciry, Smte, and ZIP Code
Under penalties of perjury, t hereby certify that Ihis Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
ancj�omple[e as required by law, and is prepared in accordance with IC 6•11-5.5, "Real Property Sales Disclosure Act".
Signature of5eller
DEDUCTIONS-
Buyer 1� Nome os appears on c�yanre documen�
Address (Number and StreetJ
P^^ceton IN 47670
�mre, and ZIP Lode
THE SALES DISCLOSURE FORAi NAY BE USED TO APPLY FOR LERTA I\
YFS
✓� � 1. Will [his property be [he buyer's prim
residence? Provide complete address
residence,including county:
Address (A'umber and StreetJ
Princeton IN 47670
Ciry. Smre ZIP Code County
Q✓ � 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
103 W Mill Street
Addrus (h'um6er and Stree�)
Patoka,IN 47666 Gibson
Ciry, Smte ZIP Cade Counry
THAT APPLY
B >-N inaaee/�nronveyanredocumen[
2407 NW 50 N
Address (Num6erand5vee�)
Princeton IN 47670
Ciry, Smte, and ZIP lode
1'FS NO COYDITION
✓Q � 3. Homestead
❑ ❑✓
❑ �
❑ �
❑ `�❑
❑ ❑✓
THAT dPPLY.
System
5. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is this property a residential rental property?
9. Would you like to receive tax statements for this
property via e-mail? (Provide con[act informa[ion
below. Please see instructions for more information.
Not availa6/e in all coun 'es.J
o�G //-//-/� '�o . o?/-- Oo� %
name
E-mail
Under penalties of perjury, 1 hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6d.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
beipg filed.) _ n �
_��� �/�--1`� \
�olreoJBuyerl SignamreafBuyer 5 ouse
� e�a �. ��v�s ;l�S��' 7i e��J �. • � �� L�F,
SocialSecurityNum6er LastSdigitso%BuyerZ/SpouseDriver's Sta[e Los[SDigicsoJSOCialSecuriry
License/lD/OtherNumGer Num6er License/ID/OtherNum6er