Homestead_Bailey (7)INDIANA SALES DISCLOSURE FORM SDF ID: PaQe 2
D.PREPARER .
Preparer a(the Sales Disdosure Form
- 9 N. Hart SL PO Box 13
rvs (Number ond Street)
Princeton.IN 47670
Ciro. Smre, md ZlP Code
E.
Name as appeors on rom�ewnre documen[
710 E Christian Street
Address (A'umber onASbee[J
Attornev
r�e `
Hall Partenheimer & Kinkle
Campany
Seller? � Nome as apyeors m mnvevanre da�vmen[
dddrexs (Number ond Street)
Ciry. Smre, nnd ZIP CoAe
E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to [he best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-L1-5.5, "Real Property Sales Disclosure AcC'.
��r Q �� io%9�fl
Signat�re f5 !er �� Signamreo(Seller
Buver 1- Name as a�s om m�verante dotumen�
Addrea (Number ond Siree�)
.•ceton.IN 47670
Smte, and ZIP Code
����
THESALES DISCLOSURE FORhI h7AY BF. USED TO APPLY FOR CERTAI.Y DEDUCfIOYS FOR THIS
1'FS NO
0✓ � 1. Will this properry be the buyer's primary �
residence? Provide comple[e address of primary
residence, including caunty:
710 E Christian Street
Address (Number ond Stree[J
Princeton IN 47670 Gibson
CiN, Smte ZIP CoAe Lounry
QJ ❑ 2. Does the buyer have a homestead in Indiana �o be
vacated for this residence? If yes, provide
complete address of residence being vaca[ed,
including county:
679 S Poolar Hilis Drive
Address (Number nnd StreeQ
Princeton, IN 47670 Gibson
Cim. Sm[e ZIP Code Counry•
Buyer 2- Name as apPears on ronveyanre dxument
Address (Number and Sveet)
Ciry. Smre, and ZIP Code
ALL OF THOSE THAT APPL1'.
—{�---�j' 4. Solar Energy Heating/Cooling Sys[em
� �✓ S. Wind Power Device
� �✓ 6. Hydroelec[ric Power Device
❑ ❑✓ 7. Geo[hermal Energy Heating/Cooling Device
� �✓ 8. Is this property a residential rental property?
� ✓❑ 9. 4Vould you like to receive tax scatements for this
property via e-mail? (Provide conmct information
below. Please see instructions/or more in/ormntion.
Not available in all counties.
�,?� -/a-Q �- � S�Q=b. � -Od �
hyllis A. Bailey
owner conma name
E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
be�g filedJ
oNre Bu��eN SignamreofBuyer2/Spouse
Ph���� B21�P�
—�
LaslSdigitsofBuyerlDriver's Smte LastSDi�i[so�SocialSecurityNumber LastSdigiLSa(Buyer2/SpouseDriver's 5[a[e Las[SDigitsoj5ocialSecurity
License/lD/OCherNumber Number License/ID/O[herNurnber
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