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Home My WebLink AboutHomestead_SilleryfND1ANA SALES DISCLOSURE FOfL�f SDFID SDOID 773273 Page 2 - Camline Schneider. � � � � � qosing Agent : � � � � � � � " � � Prtparcr.e/NeSalesDlscfmurtFOrm" � Ttl< _ � � ' . . . . ' � '`� 915 Main Street � Sutie 600 - Redional Title Services CLQ .� . � - � � � 'Adtl�(NU .6eraiNSVee[J .. - . � ' . �.'Homesale Irc..��" � � � � � . � - . . . . Sdferl-Namemappsaisonconv�anndavmm[� � ' SrIIerl.Nnmemaypeaaomm�rygnceCOComent . . . . 1400 E.NewportLenter Drive ' � � � � � - � � � � Addresi(NurMera�Stree�)� -' � - � - Addrea(Numberdr.dStmQ � ' . � � � . � Deefield Beach, FE33442- - - � � �. CIry;SmtCCndZ/PCodC �-- ' - -G:y,Sm+cv�Z(➢Cme . . � ' . � . _ . . mW ... E:mhii'� � . Tdr honef:um6er.' �. E-ma0 � Under p nald ' - e�ju ��, reby certifyYhat [his Sales Disclosure, to the 6est of my knowledge and belief, is true, correct anilto le[e re - ir �6 1�;.and�is�prepared imaccordaricewi[h.IC64:1•5.5, "Real Property5ales Disdosure Act". . SYg+mmre ols /er � . . -. . . Synaam /Sdt . - ' . ' . : . `�vvtc,�. �r o3-a 3_�? r/ I o.. Tm.�.�., . .... _.� _ . . . n��.n�umnrvww ��:.1�� . e ... C'n..Mtir�rv/n�MVV1' . Trevaun L Sillery . . . . � � � . � . � . -. . - . . . � . Buyvl-Nomemapymrsonron adovummt � � Biger2-Namevsoypevnwcdnveyanarduvmmr ' - ' � . ire� �. Pt 4 D � . . . . ,1Coms q� � «1 _ � - .lddress(NumberandSa'ta) . . . . . . Pnnceton, IN 47670- - . . . .. . � � .. - . � ?NESALESDIS[LOSUREFORNMAYBEOSEOTOAPPLYFORCERTAI\DEDORIO\SFORT TY:�IOE�TIFYAILOFTH TAPPLY _ "- �YES FO CO�OITION � YES NO - CONDITION' XQ � Q i�. Will�this proper.ry be ihe buyer s primary �� Q Q� 3. Homestead � . ��. � � �� - � � reSidence? -P�ovide.complece a8dress oi primary .mg/Cooling System � � � ,resideiice, induding muntyi � � � � O _ � S Wind Power.Device . . - � � 222 S�SEMINARYi. . � . . . -...: . - . � . � � . . Addrrsr'(Num.bcrandSGretJ. ' - ' '�� ' � Q � 6 Hydroelectnc Powe� Device � � - Princemn , IN 47870 - � � GIBSON .� �' � � � y Geo[hzrmal Eriergy.Heating/Cooling.Devite. � � . Clry.Rure2lPCOde - � " . ' ' -COUnry- . . � �... . . ��] 2..Does the buyer have a homestead in Indiana ro be., �� $� �s [his property a.resident�al renWl property? _ vacated� for�this.residence7:lf yes; provide � ❑ � 9• Would youJ�ke to receive tax statemenfs for chir � tomplere address of residence�being vacaced, property ��a e=mail? (Provide contacGinformaGOn . includin��county:�� beloiv.Ple¢seseeinstrucdons%rmoreinfarmndort. - � Notavaila6le in alPcounties.) - � � .AAAreaGVUmbmand5vretJ . . .V•/ �/��o��. �a/��V�� Vd��- �0 -CIry.StireZlPCcde � . . � [ounH� �. . -' : c... � . . -Pr'una77rvV�nl'cwnerrormctncme � rcil . . . � - . .� . ... . . _ . . ._ _. .. . . . _. . _ . �Undecpenal[ies otperjury,-1 hereby ce�tify that this Sales Disciosure,�[o the bes[ of my_knowiedge and�belief; is [rue, cprrecL aod completeas,Tequi�ed by law, andlS�prepared fn�accordance,wi[h IC 6-11-5.5, "Real Property Sales Disclosure Act". (Note: Spouse inforination;�SocialSecurity and Driver s�License/O[her numbers are no[ necessary if oo:Homes[ead Deduction (s ��. b�ein�led.) .� _ � A��. � . . . . . . . .. �� - ' . . . - . - . ' _ . ��.nryNumber .I � LasaSd(qits - Number Lic Smte LastSDigifroj5orialSecuriry