Homestead_RobbinsCLOSURE FORM SDF ID: Pa e 2
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SHANNON LIBBERT
Aeparer o(the Sala D'udasure Form
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Ciry, AutG andTJP Code
E. SELLERfSI/GRANTOR(Sl , - . __
Title
REGIONAL LAND
Compony
E-mail
RORIN F Wll FS NKA RORW F STFPHFNS
5 ller ]- Name as appea,rs an ronveyanre dxumenf Seller 2- Name as appevrs on conveyance document
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Addras(NUmberand5tre¢c) � Addras(Numberond5veet)
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Ciry, Smte and LPCode Ciry. SwtG and Z/PCode
Tele honeNum6er E-mail
Under penalties of perjury, l hereby certify tha[ [his Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and-sQmplete as requirec� by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Act".
Buyer ]- A'ame as oppears on c�nce document
s�„am.e o/sene.
Address (NUmber and Stree[)
PRINCETON IN 47670 I PRINCETON IN 47670
[iry, Sru�4 and Zlv[ode
THE SALFS DISCLOSURE FORM MAY BH USHD TO APPLY FOk CERTAIY DEDUCfI0N5 FOR THIS PROPERTY. IUEhTIFY ALL OF TNOSE THAT APPLY.
Q � 1. Will this property be the buyer's primary
residence? Provide complete address of �
residence, including county:
205 NORTH STH AVENUE
Addras(NumberandSOee[)
PRINCETON IN 47670 GIBSON
[iry, swce ZIPCade Counry.
� � 2. Does the buyer have a homes[ead in Indiana to be
vacated for this residence? If yes, provide
comple[e address of residence being vaca[ed,
including munty:
Addras (Nomber and5tree[J
Ciry, Smte ZIPCode Lounry
Q � 3. Homestead
� I.iI�4�ColarF P�.-MeaUng/CoolingSystem
� ✓Q S. Wind Power Device
� ✓Q 6. Hydroelec[ric Power Device
❑ ✓Q 7. Geothermal Energy Hea[ing/Cooling Device
� Q 8. Is this property a residential renial property?
❑ ✓Q 9. Would you like to receive Wx statements for this
property via e-mail? (Provide contact informodon
belmv. Please see instructions for more information.
Not available in all counties.)
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ronmc[nome E-moil
Under penalties of perjury, I hereby certify [hat this Sales Disdosure, to the best of my knowiedge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance wi[h IC 6-11•S.S, "Real Property Sales Disclosure Act". (Note:
Spouse inf'o�m ��on_, Sof ial Security and Drivers License/O[her numbers are not necessary if no Homes[ead Deduction is
beinefi d.� ) %iJ / / !
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Smte LastSDigifso�5acialSecuntyNumber
Lirense/10/Ofher Number
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Signamreo(Buye2 pouse
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