Homestead_Schafer (5)SDFID:
D.PREPARER
Dan L ieeves
Aeparer a/the Safu D6dosurt Fortn
� S. Main St.
s (Number ond SveetJ
P nceton IN 47670
City.Smre, and ZIP Code
EmiIPP K . nningham
Selle� 7- Name os appears on conveyon<e document
fi7Qi ifflflPElP.3f� �lIVP _ _
Addrecs (Numberond Stree[)
CTvP�CViIIP IN AJ665
City, Sm[e. and ZIP Code
rme
E-mail
Seller 2- Name os oppears on conveyance dacummt
Address (Number and Stree[)
lity. Sm[q and ZIP Code
Under penalties of perjury, 1 hereby certify tha[ [his Sales Disdosure, to [he best of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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Signamreof5eller � � SignoNreo(Seller
-APPLICATION
Buyer 1� N�pears om m�veyonce dxvment
526 E Emerson St
Address (M1'um6e� and Stree[)
P', eton IN 47670
mte. and ZIPCode
S- IDENTIFY ALL ITEMS THAT
Buyer 2- Name as aypears on conveyance documen[
Address (Num6er and5treet)
Gty, Slate, and ZlP lode
THE SALFS DISCLOSURE FORM FL1Y BE USED TO APPLY FOR [ERTAIN DEDUCf10N5 FOR THIS PROPERTY.
�✓ � 1. Will this property be the buyer's primary �
residence? Provide complete address of primary
residence, including county:
S9R F Fmorcnn�S(
Addres (Number and Stree[)
Princeton IN 47670 Gibson
City.Srn[e ZIP lode Counry
�� 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Address (Num6er ond SveetJ
lity, Srnce ZIV Code Counry
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❑✓
TNAT APPLY.
4. Solar Ener� Heating/Cooling Sysrem
5. Wind Power Device
6. Hydroelec[ric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is this property a residentlal rental property?
9. Would you like to receive [ax sta[ements for this
property via e-mail? (Provide contact lnformation
6elow. Please see instructions for more infarmation.
Not availa6le in all counties.)
aG -�a-a � aos� �i ���oa a�
name
E mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Drivers License/O[her numbers are not necessary if no Homestead Deducdon is
be�g filed.
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