Homestead_Moseby1\DIA\ASALES UISCLOSURF.FORU SDFIU SDOID 720080 Page2
D.PREPARER
C Bartett
Reyarero(the5aln Diulosvre Form Title
226 W Broadway Broatlway Title. Inc.
Addrrn (Nvmher ond Arer(J Cumpony
Princeton, IN 47670.
O.y, Srore, and2IPCoCe Telephone;tuniber E�mail
E. SELLER S GRANTOR S
Jennifer M McFGnley
Seller i- Nume us nppeun on �onveynme Jneumem Srller Z� Nume m nppran on mmpvn<e dmvmrnt
625 S Main S�.
.4ddrest (Numbn ond SoteQ ACdrtss (A'vmbrr and Strn[)
Princeton, IN 47674
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E- il TAe oneNumber P-mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to [he best o(my knowledge and belief, is true, correct
anci mplere as required by law, nd is prepared in ae rdance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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F. BUYER 5 GRANTEE S- APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEh15 THAT APPLY
Cynthia A Moseby
Buye� ]� M1'ame m vppmrs m rnnvryvnre davmen: Buyer? � Name as nppears on romryanre da[ummt
173 1/2 S Main St.
Addrra/Numbaand5ver[) AAdras(Numbrrond5:reetJ
Princeton, IN n7670.
Teleuhnne�eumber �E�mall Ts:e ane::vmbe� E-mail
THE S,1LES DISCLOSURE FORl1 MAY BE USEO TO APPLY FOR CERTAIN DEDURIONS FOR THIS PROPERTY. 1 DENTIFI' aLL OF TNOSE THAT APPL1'.
YES NO CONDITION 1'ES NO CONDRIOY
Q � 1. Will [his property be the buyer's primary Q ❑ 3. Homestead
residence? Provide complele address of primary � � 4, Solar Energy Neating/Cooling Sys[em
residence, including counry:
214 S SEMINARY ST. ❑ � 5. 4Vind Powe� DeViCe
nnereu(x�m5r�a�dsn«q ❑ Q 6. Hydroelectric Power Device
Princeton, IN 47670 GIBSON � � 7, Geuthermal F.nergy Hea[ing/Cooling Device
Ci9'. Sw:e ZI? Code Counry
�� 2. Does the buyer have a homestead in Indiana m be ❑ 0 8. Is this property a residential rental property?
vacated for this residence? IPyes, provide ❑ � 9. 4VOUld you like ro receive tax statements for this
complete address of residence being vacated, properry via e-mail? (Provide con[nct informotion
induding counry: below. Please see instructions%r more in%rmation.
�br available in all counties.)
Addras(1:vmberar.dSvrcQ
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Ci9c Smce Zl? CWe Counry
Pnmarypmperry o�wer con[aa nvme h'�mail
Under penal[ies ofperjury, 1 hereby certi(y tha[ [his Sales Disclosure, to the best of my knowledge and belief, is [ne, correct
and complete as required by law, and is prepared in accordance with IC 6d1-5.5, "Real Propert}� Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/O[her numbers are not necessary if no Homestead Deduction is
bei g filed.)
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