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INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2-
D,PREPARER , ; -
SHERI L. GREENE
Preparera(Ne Salu Dlulosurc Form TiUe
1122EOHIOST
Address(Nvmberand5bee[)
E-mail
E. SELLER S GRANTOR S �� � - � � � � ' � �
CFF PREVIOUS PAGE
Seller ]� Name as appmrs om m�veyonre docvment Seller Z- Nome as appears om m�veyance dotummt
Address (Nvmber and Svret) Address (Number ond Svee[)
Ciry, SmrC and ZIPCOdt Liry, Sm¢, andZlP Code
Tefe honeNumber E-mail Tefe honeNUmber E-mail
Under penal[ies of perjury, I hereby certify that Ihis Sales Disclosure, to [he best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Act".
S{qnamre of5elfer Signaare o/Seller
dNamCO Sellet SiOnDale NH DO AlnledN01ne0 Stller Si n0a[C NM 00
. BUYER S GRANTEE 5- RPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY�ALL ITEMS THAT APPLY
JENNIFER TERRI CAIN
Buye(Z-Nameasayyearsonronvryan avment Buyer2-Nameasappeanontonveyancedocvmen[
0 t�
A � NumberandStree[) Addres(Numberand5treet)
RINCETON �IYG7&—
Ciry.Srare. andZ/PCOde Ciry, Smu, andllP Code
E-mail iele honeNumber f-mvil
TNESALFSUISCLOSIIREFORMAUIYBEUSEUTOAPPLYFORCERTAIYDEDURIONSFORTNI ROP Y.IDEER'��TIiYA�LL FTN6 THATAPPLY.
YFS NO COKDITION 1'FS NO CO\DITION
Q✓ � 1. Will this property be the buyer's primary ❑J ❑ 3. Homes[ead
residence? Provide complete address of pri a � � 4. Solar Energy Heab ooling Sys[em
residence, including county:
. wer Device
Addrus(A'vmberand5treet) ❑ Q✓ 6. Hydroelectric Power Device
PRINCETON IN 47670 GIBSON � Q 7, Geothermal Energy Heabng/Cooling Device
[iry, Smu zIP Code [ounry
� Q 2. Does the buyer have a homes[ead in Indiana to be � ❑`� $� �s this property a residential rental property?
vacated for this residence? If yes, provide ❑ 0✓ 9.4Vould you like to receive tax statements for this
comple[e address of residence being vacated, �lMM�� pp '' p``�pye v' e-mail? (P�ide_ contact i madon
indudingcounty: 7'�,�,g,�--���' u h �('qyy���'(
" -d � Notavailable in 1 co�mir
Address (Num6er andSUee[J
o?�- ��-Q �-3o3-ar/. 2- oa g
Ciry, Srare ZIPCode Counry
Pn'mary pmperry ownercanmc[ name E-mail
Under penal[ies of perjury, 1 hereby certify [hat this Sales Disclosure, [o [he best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disdosure Ac[". (Note:
Spouse information, Social Security and Driver's License/Other numbers are no[ necessary if no Homestead Deduc[ion is
bein filed.)
� � ���� � �
Si n mrco(Buye Signamreo(BUyer2/Spouse
Pnn¢d Legal Name oJBvyer 1 Sign Dore (MM/DD/YYY17 Pnnred Legnl Name o(Buyer 2/Spouse Sign Dare (MM/UD/YYYY7
ocialSecurityNumber LastSdigiGSO%Buyer2/SpouteDnver's Stute LastSDigifso�5otia15ecurity
License/lD/OtherNumber Num6e� License/1D/OtherNumber
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