Homestead_PrinzingI\DIA\,�SALESDISCLOSURF.FOR�1 SDFID SDOID 734098 Page2� \
D.PREPARER `
'Samantha Cuisinger
R'eyarcr oJthe Sclo Oudasvre Fo�m Ti!!e
I226 W. BroaWray Broadway Title, Inc.
Addras(Num4eron�SVeetJ Campany
Pnnceton, IN 47670.
Seller 1- Name vs appevis w mnve��ume drcument
1523 Willowbrook Dr.
Addrm (Number ond 5[rnlJ
Princeton. IN 47670.
BrarMi L Vela
Se(Irr2 � Nume as uppeors om m�vewnae dorumem
1523 VJillovArook Dr.
AElrtss (NUm6er a nd Svre[�
inceton. IN 4767P
a.
'��
Under penalties of perjury, 1 hereby certify that Ihis Sales Disdosure, to [he best of my knowledge and belief, is true, correct
and compl,rt� as req}iire�l b�y law, and is prepared in accordance with IC 6-1.1�5.5, "Real Property Sales Disclosure Act".
-APPWCATION FOR
W Prinzina IV
IN a7670.
idryGone Numbe� E�mmi
THE SdLFS DISCLOSURE FORM MAY BE USED TO APPLY i00. CERTAIN DEDUL710N5
Q � 1. Will chis property be the buyer's primary (
residence? Provide complete address of primary
residence, including munty:
1523 WILLOWBROOK DR.
Andreu (NUmber and Svee�)
Princeton, IN 47670 GIBSON
Ciry, Smre ZIPCOde Counry
X❑ � 2. Does the buyer have a homestead in Indiana ro be
vacated for this residence? If yes, provide
complete address of residence being vacated,
induding counry:
2108 TAYLOR AVE.
Addrerz (NVm6er and5'vre:)
Princeton, IN 47670 GIBSON
[iry. Smre ZIPCode Covnry.
Michelle L
2108 7avbr Ave.
Adtlrrxs (Numbrr and Shee�)
Princeton, IN 47674
C�y. Smu. and ZIP Code
APPLY.
av�,�
Qx ❑ 3. Homestead
�— . ar �nergy Heating/Cooling System
� Q S. 6Vind Power Device
� Q 6. Nydroelectric Power Device
❑ Q 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is this property a residential rental properry?
❑ Q 9. 4VOUld you like to receive [ax statements for this
properry via e-mail? (Provide contnct information
below. Please see instrucdons%r more information_
Not available in all counties.J
!'-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, [o the bes[ olmy knowledge and belie(, is true, correct
and mmplete as required by lae�, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Ac[". (No[e:
Spouse information, Social Security and Driver's License/Other numbers are aot necessary if no Homestead Deduction is
bein filed.) J. .^�,� ^ '�t �Q��^
/ �L � 1/
S/ign'omre Buyerl � l-_ � �ignamreo/BvyrrT/Spoust/ / /�
L�dn� �n� !/�12i�"'SL- �/i�%��' �..�,i..,r.Q. � . ���nZ�l^-< �71�'J���-'
Pdn[e egolNamtUfBUy'e�l � Sign S� /DD/Y55'17 PnncedLrgal,YOmrofBuye�7/Spoure $i9nOCfe(MN/00/YYYI')
(, �
Social5eaunty
License/ID/OtherNumber A'umber Girense/lD/OthtrNumber