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Sefler 1- Name os aypmrs m conveyance do[vment Shcer 2� Name as appears w cwveyvncedacvmen[
2905 E 100 N 2905 E 100 N
Addrm (Number and Sveet) Addrcct (Numberand Svee[)
Princeton, IN 47670 Princeton, IN 47670
Ciry, Sm[� and ZIPCOde Ciry, Smtq and ZIV CWe
iele honeNvmbe� E-mail ide honeNUm6er E-mail
Under penalties of perjury, 1 hereby cer[ify [hat [his Sales Disclosure, to the bes[ of my knowledge and belief, is true, correc[
and ymple[e as re uired y law, and is prepared in actordance wi[h IC -11- ,"Real Proper[y Sales Disclosure Ac[".
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Matthew
Bvya 1- Name at app
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TNE SALES DIS[LOSURE FO{N1 MAY BE USED TO APPLY FOR CERTAIN DEDUCf10N5
� � 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
2905 E 100 N
Addrm (Number and Stree[J
Princeton, In 47670 Gibson
Ciry.SmreZlPCode Caunry
� � 2. Does the buyer have a homes[ead in Indiana to be
vaca[ed for [his residence? If yes, provide
complete address of residence being vaca[ed,
including county:
AAdrm (NUmber and Svret)
Code Counry
1'R�%�:U��
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APPLY.
Heatlng/Cooling Sys[em
� � 5. Wind Power Device
� � 6. Hydroelectric Power Device
❑ � 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is this proper[y a residen[ial rental proper[y?
� � 9. Would you like to receive tar sta[emen[s for [his
property via e-maiR (Provide contact information
below. Please see instructions for more information.
Not available in a roundes.)
o?G-/o4-03_ ��' �00. dG-D�-,
name
E-mail
Under penalties of perjury, 1 hereby certify [hat this Sales Disclosure, [o the bes[ of my knowledge and belief, is Lve, correc[
and complete as required by law, and is prepared in accordance with IC 6d.1-5.5, "Real Property Sales Disdosure Act". (Note:
Spouse informa[ion, Social Security and Driver's License/O[her numbers are no[ necessary if no Homes[ead Deduction is
being filed J `
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