HomeMy WebLinkAboutHomestead_Wagner (3)�
Kimberly A. Lewis
Preparer of the Soles D'udosvre Fo.m
226 W. Broadway
Addre[s (h'um6er and Stree[)
Princeton IN 47760
Ciry.Sm:t and ZIPCOde
Deborah E. Kolb
Selfu I� Name as apymrs on ronveyanre documen[
409 N. Lincoln St.
Add�ess(Numberand5tree[)
Princeton, IN 47670
�L /y1
Office Manager '
Title
Broadway Title, Inc.
Compony
—�
Under penal[ies of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is [rue, correc[
and com/py1/��,e as required by law, and� is �pr/ep� red in accordance with IC 64.1-S.S, "Real Property Sales Disclosure Ac[".
�Signatureo/Sel� � Q � Signamrco(Seller
lJnL,rl/�. L 4 /�/i) /O/�S�/�%
Melanie G. Waqner
iv I- Name as aop�rs on ronvryonredocumen[
210 S. Fourth St.
47670
ThE SdLFS UISCLOSURH FORM MAY BE USED TO APPLY FOR CERTAI\ DEDUCf10N5 POR TNIS
� � 1. �4'ill this property be [he buyer's primary
residence? Provide complete address of prima
residence includingcounty:
409 N. Linco�n St.
Addres (Number and5trre[J
Princeton IN 47670 Gibson
Ciry, Sm¢ ZIPCade Counry
� � 2. Does [he buyer have a homestead in lndiana to be
vacated for this residence? If yes, provide
comple[e address of residence being vacated,
induding county:
(Nvmbe� and Stree[J
Ciry. Smte
Bvyer 2� Name os appears on conveyance dxvmen[
Address (Number and Strert)
Ciry, Srart
� � 3. Homescead
� �
� S'�
■ i�7
� 1:.
� ��
APPL1'.
System
5. 4Vind Power Device
6. Hydroelec[ric Power Device
7. Geothermal Energy Heabng/Cooling Device
8. Is this property a residenrial rental property?
9.lNould you like to receive [a� s[atements for [his
property via e-mail? (Provide contoct information
below. Please see ins[ruccions for more injormation.
Not available in all coundes.)
/L i . � � ��! � �/i �
mn[ocf name
E mail
Under penalties of perjury, I hereby cer[ify [hat this Sales Disclosure, [o [he bes[ of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Ac[". [No[e:
Spouse informa[ion, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.) � �
IPnnfedLegolNameafBuyerE �/ SignUa[e(MM/�0/YYYt7
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LastSdigiGSOjBuyerlDriver's Sm[e LastSDigiGSO(Sacial5ecunryNum6er
Liceue/ID/OrherNum6er -
SignaNre o/Buyo1/Spome
Pnnled Legal A'ame
Sign Dafe (MM/DO/YYYi7
LastSdigiGSO�Buyer2/SpouseDnver's Smte LastSDigiuojSocialSecunry
Number License/lD/OtherNum6er