Homestead_Loechler(/
L�DIA\p SdLHS DISCLOSURE FOR�I SDF ID SDO ID 466188 �Page 2
D. PREPARGR = °- � . - � . . - �
�Kimberty A. Levris Office Manager
Aeparer oftheScles Diufosvre Form Title
226 W. Broadvrdy Broatlway Title, Inc.
Addros(NvmHeroiMSVerfJ Comyany
Princeton, IN 47670.
Grv, Sm¢, andZlP CoEe Telephone Number E-mall
E. SELLER S GRi1NTOR S
BettyJ.Tenrryson
SrHer ]- Xame as appeors ort ronveyvnce dorument Srflrr2 � Nome os appevn-on mmcyan�e dorvmrn(
706 Wilson Ave.
Address (Number ond Sa'eetJ Addrers (NUmberandSVttQ
Princeton, IN 47670-
Ciry,Smte,
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Tefr huneNUmber E-muil Tele aneNum6er Emnil
Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, to the bes[ o(my knowledge and belie(, is true, correct
and complete as required by law, and is prepared in acrordance wi[h IC 64.1-5.5, "Real Property Sales Disclosure Act".
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Signo ca/Se r _— SignomrroJScller
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F. BUYER S G Y�- E S-APPLICATION'FOR PROPER � TAX DEDUCTIONS- IDENTIEY.ALL ITEMSTHATAPPLY
John R. LoeUler
Bu}�erl-Nome pearsomm�veyoncedocvmen: Bwer2-Nameasnppevrsomm�veimnredoavment
. ollins St.
Address(Num6erandSVee[J ddEras(Numberand5treeQ
Oakland Ciry. IN 47660-
Emoil Td AoneRVm er E�mail
TNESALES�ISCLOSUREFOR.\IMAYBEUSEDTOAPPLYFORCEHTAI,YDEDURIONSi PROPERTY.IOENTIF1'ALLO SETHATAPPLS.
VES NO CONUITION tF5 NO CORDITi08
x❑ ❑ 1. Will this properry be the buyer's primary Q � 3. Homestead
residence? Provide complete address of primary , ar �nergy Heating/Cooling System
residence, induding county: ❑ �
2a08 E. IAKE RD. 5. �Vind Power Device
,Iddress(Num5erond5veec) ❑ � 6. Hydroelectric Power Device
Princeton, IN 47670 GBSON � � 7. Geothermal Energy Headng/Cooling Device
Ciry, Smce ZlP CoCe Counry
��] 2. Does the buyer have a homestead in Indiana m be � �$� �s chis propercy a residential renial property?
vacated for this residence? If yes, provide ❑ Q 9. 4Vould you like to receive tax sta[ements for this
complete address of residence being vacated, property via e-mail? (Provide contact in%rmation
indud ing county: below. Please see instructions%r more informadon.
No[available in all counties.)
Addres (Nomber mA SamtJ
aL -��-oe�_oz�s�.00.3. a9f� a�
Ciry,SmteZlPCOde Counry
Primarypmperry o�wo ror.mc! name E-mail
Under penaltles of perjury, 1 hereby certify that this Sales Disclosure, to [he bes[ of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure AcC. (No[e:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deducrion is
being filed.)
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License/ID/O[herNumber ' Number Litente/ID/OrherNumber