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Homestead_GreenINDIANASA LES DISCLOSURE FORM SDFID SDO ID 722262 Page 2: D. PREPARER Samantha Cutsinger Preparer of the Sales Duclosure, Form Title 226 W. Broadway Broadway Title. Inc. Address (Number and Street) E. SELLER(S)/GRANTOR(S) Can E Mayberry Seller) A'amemvppenn on mnveynmeJrcumem Seller-2 - Namens.,pearsoomovynmedocument 9018 E 400 S Address (Number and Street) Address (Number and Street) Oakland City, IN 47660 - Tele hone Number 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 with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". .tignonme afSelfer .Signature ofsdler f�ALL � a- - / .BUYERS GRANTEES -A LICATIONFORPROPERTYT UCTIONS- IDENTI ITEMS THAT APPLY nis R Green Shannon L Green Buyer I �A'ame aoneanveyance document - _ ,r_ .canvesnnce document 214 E. Main St. 214 E. Main St. Addren (Number and Street) Address (Number and Stre,) anpsco, IN 47649- Francisco, IN 47649- YES No CONDITION I N0 CONDITID x❑ ❑ 1. Will this property be the buyer's primary Q ❑ 3. Homestead residence? Provide complete address of primary seating /Cooling System residence, including county: [] 5. Wind Power Device 9018E 400 S ❑ © 6. Hydroelectric Power Device AddressiWtmberandSueer) Oakland City, IN 47660 GIBSON ❑ ❑ 7, Geothermal Energy Heating /Cooling Device City, State ZIP Code Counry x❑ ❑ 2. Does the buyer have a homestead in Indiana to be ❑ © B. Is this property a residential rental property? vacated for this residence? If yes, provide ❑ © 9. Would you like to receive tax statements for this [, complete address of residence being vacated, property via e-mail? (Provide contact information J including county: below. Please see instructions for more information. 214 E. MAIN ST. Not available in all counties.) Address (Number aodStreet) Francisco, IN 47649 GIBSON 4 �� / / a�� / 9 7 dO City, State ZIP Code County CCU! L Primary property onmer coo. met 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 with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note: Spouse inf rmatio Soc• 1 Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is being filed. ^// o c_W Sig�°(''re of Buyer) p St&arure o^ f�pousa Null