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INDIANA SALES DISCLOSURE FORM SDF ID: �� � Pa e 2
D. PRF.PARER . _i . - - - : �, : _
Robert P. Carithers Attomev at Law
Preparcro(rheSa/aOkdosureForm Title
� 706 Court Street P. O. Box 1707 Trimble & Jewell
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E. SELLER S GRANTOR S `'
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Olive Jean ShoulAers
Se/ier 1- Name as aAPean on ronveyvnae dacvmm[ Seller2 � Nome as appeurs om m�veyanre darummt
623 E 250 S.
Address (Nvmberand StreeQ Addres (Number and5tr'ee[)
Princetoa IN 47670
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Under penalties of perjury, 1 hereby certify tha[ [his Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Proper[y Sales Disclosure Ac[".
Signam��elltr i v�� q I Signamrro(Seller
Olive Jean Shoulders ,� OL ���
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. UYER S GRAN S=�AFPLICATION-FOR PROPERTY-TAX'DEDUCTIONS-�IDENTIFY-ALL�ITEMS.THAT�APPLY�=;� ` --.�;� :' :
Carol J. Snoulders
Buyerl-Nameasapp nconvqvnttdocvmenl Buyer2-Nomeasappearsonronveyancedavmrnt
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Princeton IN 47670
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THE SALES DISCLOSIIRE FORM MAY BE USED TO APPLY FOR CERT.IIN DEDUCf10NS FOR TNIS PROPERTV. IDENTIFY ALL OF THOSE THAT APPLY.
YFS RO CO\DRION NO CONOIT .
❑✓ � 1. Will this property be the buyer's primary (❑✓ ❑ 3. Homestead
residence? Provide complete address of prim , -nergy Heating/Cooling System
residence, induding county:
623 E 250 S ❑ ❑✓ 5. Wind Power Device
Address(h'umberandSVre[) ❑ ❑✓ 6. Hydroelec[ric Power Device
Princeton.IN 47670 Gibson � Q 7.GeothermalEnergy Heabng/Cooling Device
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� �✓ 2. Does the buyer have a homes[ead in Indiana to be � ❑� $• �s this property a residen[ial rental proper[y?
vaca[ed for this residence? !f yes, provide ❑ ❑✓ 9• Would you like to receive taac sca[ementr for [his
comple[e address of residence being vacated, property via e-mail? (Provide rontact informadon
induding county: 6elow. Please see instructions for more information.
Nat avai(able in all coundes.J
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Under penal[ies of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is [rue, correct
and comple[e as required by law, and is prepared in atcordance with [C 6-1.1-5.5, "Real Property Sales Disdosure Ac[". (Note:
Spouse information, Social Security and Driver's License/Other numbers are no[ necessary if no Homestead Deduction is
bein filed.)
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