Homestead_Brines (4)SHANNON LIBBERT
� Neparer o(Ne Sala Disdosure Form
Addrgs (Nvmber and SveetJ
TiHe
REGIONAL LAND
Compvny
�
EVANSVILLE IN 47715
PRWCETON NFW LIFE CHIIRCH OF THE N�7ERENE. INC.
Shcer ]- Name us appmr1pm m�veyance dor,qmen �
Ciry,
and
-
PRINCFTON NFW I IFF CHURCH OF THE NA7FRENE INC
Seller2-Nomeasapp�e�ors�omm�veyance�ocuf`'fnt
/%�`� Cc'//crcv�ab A/�� �
revs (NUmber ond Stree[)
r.nc�� � � � °{7�70
[iry:5mte.andZlPCode ��
�! A��
Under penal[ies of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is [rue, correc[
omplete as require aw�a r ared in accordance wi[h 1 6-11-5.5, "Real Property Sales Disclosure Act".
�� G� �� ��,
(gnam�e f5eller Stqnamreo(Se/ler
BY GARY WAYNE ARNOLD PASTOR. PRFSI DS_—�S�—�D�� DONNIE TRUELOCK. SEGRETARY OS-a�-��ij
R S GRAN � E S-APPtiICAT10N.
\
���/
Smre,
IS THAT AP.PLY -'�- -
documen[
�
U%��1a
� �
THE SALFS DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAI\ DEDUCf10\5 FOR THIS PROPERTY. IDE\TIFY ALL OF TNOSE THAT APPLY.
� � 1. Will this property be the buyer's primary
� residence? Provide complete address of primary
residerp��i�cl4ding county:
� ��i�� `{J'4`!'Dr� 4.CX'>1 � •
s (NUmber and Sv(e[)�
C' 1 lS t�CJ41 '� u �
Ci ,SmteTJPCode Counry
� 2. Does [he buyer have a homestead in Indiana fo be
vaca[ed for [his residence? Ifyes, provide
comple[e address of residence being vacared,
_ _ including county:
Ciry, SmteZlPlode County
�✓ � 3. Homestead
� Q 4. Solar Energy Hea[ing/Cooling System
� �✓ S. Wind Power Device
� Q 6. Hydroelectric Power Device
❑ ❑✓ 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is [his proper[y a residential rental property?
� ❑✓ 9. Would you like to receive tas statements for this
property via e-mail? (Provide contact informodon
below. P/ease see instructions far more information.
No[ ovoilo6l in oll counpes.) a�
!J�j}(�p /�� _ �j_OQ3. 3/�
AfJ�ELA R HUME iI�
Pnmory o�opertyawner mnmtt nome E-moil
SjgnoNreo vyer2/Spouse �
ANf;FI A R HI IMF .�'��� -''
Pnn[edLegolNameofBvyell/Spouse SgnDa[e(MN/DDjvYYF7
�, �
SpouteDrirer'S Smte Las[SDigitto(SocialSecunry
Num6er License/lD/OCherNumber
1!