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• IilDL�Nd SAL S DISCLOSURE FOR\I
SDF ID
D: PREPARER� � � .- . . . :.- -.. .
Saman(ha Cutsi er
Rryarer o/che Scles Oiulosure Form
226 W. Broativray
Addren (Nvmber aMSVeeIJ
Princeton, IN 47670.
Ciry, Srutp ondLPCade
Seller 1� Name as ap�uars on �unveymae dm�mmt
7307 S 200 W
q ddress (Num6er and Sovec)
Princelon,IN 47670.
Cig",Smta andZlPCode
Ii � �_-'.
SDOID 464594
Page 2 ;
�
TiUe
Broadvray Tiile, Inc.
[ompoq
TelephoneNOmDer E+nall
Mindy J Bnnes
Sdier 2� Nvme as appenrs on ronveyvnoe dcrument
1301 5 200 W
AdCrzn (A'umber ond5veet)
Princeton, IN 47670.
Ciry, Smtt, and 21P Lode
Under penalties of perjury, I hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required byaaw, and is prepared in accordance with IC 6d1•5.� "Real Proper[y Sales Disclosure Act".
LICATIONfOR
erertry F Vaal
Buye�l�Abmea
Address (Numbn onE Svee[)
Princeton, IN 47670.
S o
as appearsom m�veyvnce derument
AGEr¢s (Number and Srreet�
Ciry.Smtz and7JP Code
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY f00. CERTAIN DEDULTIONS FOR THIS PROPERTY. IDENTIFI' TLL OF TNOSE THAT APPLY.
❑x ❑ 1. Will this properry be the buyer's primary
residence? Provide complete address of pri ary
residence, including counry:
1301 S 200 W
Addres(NUmSerend5vrevJ
Princeton, IN 47670 GIBSON
C(ry, Smce ZIP lode Caunry
�� 2. Does the buper have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
includingcoun[y:
Add2rs (Num6er ar.dSvreQ
Gry. Sm¢ LP Code
Y'ES NO CO\DITIOY
Q � 3. Homes[ead
4. Solar En ieating/Cooling System
� Q 5. �Vind Power Device
� Q 6. Hydroetectric Power Device
� Q 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is this property a residen[ial rental property?
� Q 9. Would you like to receive tax statements for this
property via e-ma il? (Provide contnct informotion
below. Pleose see instrucnons%r more in%rmation.
hbta ailoble in all counnes.)
aG -�r-i�3o� -ooa. 8yi- �a �
Pnmarvvivx�NOwnfrmr.m[lnam[ Email
Under penalties of perjury, I hereby certify that this Sales Disclosure, [o the best o(my knowledge and belief, is true, correc[
and complete as required by IaN�, and is prepared in accordance with IC 6-1.1-5.5,'Real Proper[y Sales Disdosure Act". (Note:
Spouse informa[ion, Social Security and Driver's License/O[her numbers are not necessary if no Nomes[ead Deducuon is
bein�g filed.)
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Lirertce/lD/Othu Number
Las[SdigiGSO%Buyer2/SpouseDnveri Smu LastSDigi[so(Socia(Secunty�
A'umber license/ID/OrherNumber