Homestead_Greenwell (9)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D.PREPARER `
SHERI L GREENE
heparer a/rhe Salu D&dosure Fo`m Title
1122 E OHIO ST
Address(Numberand5tree[) Campvny
PRINCETON. IN 47670
E-mail
E. SELLER S GRANTOR S
THERE¢q GOLI INS
Shcer 1- Name as appears on ronveyvntt dotummt Seller 2� Name as oppears on mmeyance datumml
1405 S VIRGIL BLVD
Addrzss (Numberand5veetJ Addres (Number and SveeQ
PRWGFTON IN47670
City, Slate, and Z1PCodr Ciry, Sra[e, and21P Code
E-mail Tele honeNum6er E-mail
Under penal[ies of perjury, 1 hereby cer[ify [hat [his Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and�o ple[e as requi ed b law, and is prepared in accordance wi[h IC 6d.1-5.5, "Real Property Sales Disclosure Act".
PRINCETON IN 47670 GIBSON � Q 7. Geo[hermal Energy Hea[ing/Cooling Device
Ciry, Smte ZIP Code Counry
� Q✓ 2. Does the buyer have a homes[ead in Indiana to be � ❑� $• �s this property a residential rental proper[y?
vacated for this residence? If yes, provide ❑ ❑✓ 9. 4Vould you like [o receive tar statements for [his
complete address of residence being vacated, property via e-mail? (Provide contact informodon
including county: below. Please see instructions for more in�ormapon.
Nat available in all munpes.J
Address(Num6erond5vee[J �� -/� � n /O � - O • O
(/, ao o8-oa
Ciry. Smte ZIPCode Counry
Pnmary pmperry ownrr mnloc[ nome E-mail
Under penal[ies of pery'ury, I hereby certify [hat this Sales Disclosure, to the bes[ of my knowledge and belief, is [rue, correct
and comple[e as required by law, and is prepared in accordance wi[h IC 6d.1-S.S, "Real Property Sales Disclosure Act". (No[e:
Spouse informa[ion, Social Security and Driver's Lic nse/Other numb �s are not necessar if no Homestead Deduction is
being f d.) '
Signamreo(Bm• Sig. aNreo/Bvyer2/Spouse
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ial5ecunryNum6er Las[Sdigi[�o�Buyer2/SpouseDriver's 5[a[e Las[SDigitto(SocialSecunty
Lirense/ID/OrherKum6er h'um6er Lirense/ID/OtherNum6er
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