HomeMy WebLinkAboutHomestead_BrouseI\DIA\A SALES DISCLOSURE FOR�I SDF ID 26-2009-1000528
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� SAMANTHA CUTSINGER BROADWAY TITLE, INC.
Preprsrei of�he Sa(d D'ucloturr Form Title
226 W. BROADWAY BROADWAY TITLE, INC.
ede.�„ (v�mb�.a„es.�er� co„�,,.
PRINCETON, IN 47670 (
E-mal!
LINDA M MASON
Sr11el.Nmneorappearrunromcyc.rcedavn J
1008 S STORMONT ST.
Ad}rtss (,VUmber cnd Svre+J
PRINCETON, IN 47670
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oi oppeun on canve�nxe
A u(tiumbermdSi�ert/
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Telrphor�e 1'um.bn E-mci/
penalties of perjun•, I hereb}' cerrif�� [hat this Sales Disclosure, lo the best of my kno��'Iedge and belief, is true, correct and
te as required by� law, and is prepared in accordance �rith 1C 6-I.1-5.5. "Real Property Sales Disclosure Act".
AMY R BROUSE
3fiJS57H AVE., APT 28
AE�ess (,\5�mhrr und 9ree+1
PRINCETON, IN 47670
r I. Will this property be the buyers primary residence? Provide compleie
address oPprfmary rcsidence, includine counry:
7008 S. STORMONT ST.
AdAreu (.�S�mbe. and Arc�rl
PRINCETON, IN 47670 Gibmn
Cirv. Smrc. and LP Calr Counrv
r?. Does thr buyer have a homestead io be ��acated for ihis reiidenee? If
}�es. pro�•ide tomplc�c address of res9dznce vacacing, includinq counp•:
.IAJrc.v (•�'u �andStirrt)
Cip•. Smrr. andLPCMt Caunrc
Aimrd.Ymne ofSel(e. Sign Dae �Af.H/DORIrr
ITE�iS 9
Bv o-��'ome ar appeurs on comn�mse dacvnrcru
Ademsr (.�1'umhcr urtJSrrsni
TdryhonrA'umba E-mai/
r; 3. Flomesiead
r ti. Solar Enerev Hea[ing/COOling $}'Stem
r 5. Nind Power Deeice
r. 6. Hydroelectnc Power De��ice
r i. Gcothertnal Enzr�� Flcating/Cooling Dcvice
r 8. Is chis propem� a residential rcn�al propern•^
r� 9. R'ould }•ou like to recieve �as statements for this propen}• via
e-mail? (Provide conmci iniormaiion (rlow�. Pltase see �he
insnvc+iw¢ (or more informotiort.:Vpr wai[eble in al( counties.l
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Untler penalites oi perJun'. I nereb}' Certii)'tnat tn15 JaIPS u�sclosure, to tne Dest ot m.' KnoN'ICUve ana De1�eL Is true, correct ana complete as
required by IaH�, and is prepared in accordance �+ith IC 6-I.1-55, "Real Property Sales Disclosure Act". (\o[e: Spouse Informa[ion, Social Securin�
and D�{iver's Licensrlother numbers are not necessary if no Humestead DeJucriun is being filed.)
Sign Dare f,N.N/OD4'Y}7l