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Title
� 219 N. Hart St.. PO Box 73 Hall. Partenheimer 8 Kinkle
Address(Numberand5vee[) Companv
Princeton. IN 47670
CiN. State, and ZIP fode
E.
Seller 1� A'ome as appeors on ronveyanre dorument
a�i � �an w
Address (Nvmber and Street)
liry, Sm[G vnd ZIPCade
�'!�? �,� -
Seller 2- Name os oppears on ronvevmce dormnent
Addrecs(Numberand5veet)
CiN, Smre, and ZIPCade
E-mail
Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and �epared in accordance with IC 64.1-5.5, "Real Proper[y Sales Disclosure Act".
� y �
Buye� 1 � Name as
Ciry.Smre. and ZIPCode
THE SdLFS DISCLOSURE FORM MAl' 6E USED TO dPPLY FOR GERTdIN DEDUCf10\5 FOR THIS
YFS NO C0IDITION
� Q 1. N'ill this property be [he buyer's primary
residence? Provide comple[e address of pri
residence, including county:
471 S 3A0 W
Addrea(Numberand5veetJ
Princeton. IN 47670 Gibson
liry, Slatt ZIPCade Counry
� Q 2. Does [he buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
induding counq�:
Address (Number and Svee[J
Ciry.S�u[eZIPCade CounN
Signomre o/Seller
Name
8vyer 2� Name as oppevrs m mnveyonre drcument
Addras (Num6er a nd SveetJ
Citv. Smte. and Z/PCode
❑✓ ❑ 3. Homestead
❑ ❑�
� �
❑ �
APPLY.
4 Solar Ener�leaCffig/Cooling Sys[em
S. Wind Power Device
6. Hydroelectric Power Device
7. Geo[hermal Energy Heating/Cooling Device
8. Is [his property a residen[ial rental property?
❑ QJ 9. Would you like to receive tax statements for [his
property via e-mail? (Provide ronmct informotion
belaw. Please see instructions for more informa[ion.
q/ Not avai'la/ble in all counties.)
JasonDavi�Swa��� r���Q�O�.g��' 6a7
Pmm�rvnrvnerNOwnrrronmctname E-mail
Under penalties of perjury, 1 hereby certify [ha[ [his Sales Disclosure, to the best of my knowledge and belief, is W e, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1•5.5, "Real Property Sales Disclosure Act". (Note:
Spoysg inform�tim�Social Security and Driver's License/Other numbers are no[ necessary if no Homes[ead Deduction is
af Buyer7
Signooire o(Byrr2/Spouse
PnntedlegalNomeo(Buyer2/Spouse
S19� DOL¢ (MH/DD/YVYVJ
LostSdigi[so%Buyer7/SpouseDriver'S Stote los[SDigiLCOfSocialSetunty
Number Gcense/ID/OtherNumber
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