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71�DIAYA SALES DISCLOSURF. FOR�f
Addros(NamberaMR
�rinceton,IN 47674
Gry. Smtt, anEZIP Code
SDFID SDOID 778349 Pagt2 r
Title
Broadxay Title. Inc.
Jana L Mitchell
Srlkr ]� h'vme vs appenn on �unvnanir Jrcumrn�
1807 W Brumfield Ave
Addrat(NUmberand5veer)
Princeton, IN a7674
Cip', Stnae, andZfPCOde
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,;,
Seflir'2 - Ncme as appevrs on mmawn�e dorumrnr
ACdrm (Abmber and5vttt)
Ciry, Sm:c, nnAZIP Cade
Under penalties of perjury, I hereby certi(y tha[ this Sales Disdosure, to the best of my knowledge and belief, is true, correct
. n� complete� required by Iaw, and �prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act".
�UVILnJ VM1�141i
Yory R Dong
Bu}rrl-A'omensop�enrson eyv
Addms (A'u mber and Svee[J
Princeton, IN 47674
s;y�om.P a/s�ue.
FOR PROPERTYTAX DEDUCTIONS-:IDENTI
THE SALES UISCLOSURE FORA1 MAY BE USED TO APPIV POR CERTAI.Y DEDURIOYS fOR THIS
Q � 1. Will this property be the buyer's primary
residence? Provide complece address of prima
residenre, including county:
1801 W BRUMFIELD AVE
Addrest (NUmbcr md Sueeo)
Princeton, IN 47670 GIBSON
Ciry, Srou ZIPCoCe Counw
�� 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vaca[ed,
including county:
Addrem (A'um6er a�dS'vn:)
Ciry, Smce 21PCoCe Covnry
Buver? � Name as appevrs on ronvewnce
Address(NUm6erandSrterQ
Ciry. Smre.
❑x ❑ 3.
APPLY.
lieating/Cooling System
�bVind Power Device
6. Hydroelectric Power Device
� Q 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is [his propercy a residential rental properry?
� Q 9. 4Vould you like to receive tax scatemencs for this
properry via e-mail? (Provide conmct informotion
below. Pfease see instructions jor more in�ormation.
Not available in all counties.J
� a -io��
name
Under penaltles of perjury, I hereby certify that this Sales Uisdosure, to the bes[ of my knowledge and belie(, is true, cortett
and comple[e as reyuired by IaN�, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[". (Note:
Spouse information, Social Security and Driver's License/O[her numbers are not necessary if no Homestead Deduction is
being filed�) _ � _ _
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