Homestead_Pollock (2)INDIANA SALES DISCLOSURE FORM SDF ID: Paqe 2
D.PREPARER
?repareraj the Soles Dittlosvm Farm
PO Box 13 219 N. Hart St.
'res (Num6er ond 5[reet)
nceton IN 47670
Ciry, Ante, and 21P Code
E.
David �nittadaiirio
Seller 7- Name as appears m conveyanm dotumen[
9754 W Columbia Fstatec
Addres (Num6er and S[reet)
Princeton IN 47670
City,
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E-mml
Title
Hall. Partenheimer & Kinkle
E-mail
Sta�,y L Gruttadaurio
Seller 2- Nanre as appeorsm mrrveyonre dowment
935d W_ Cnh�mbia Fctatec_
Addres /Numberord 5tree[J
Princeton.IN 47670
E-moi/
Under penalties of perjury, 1 hereby certlfy [hat this Sales Disclosure, to the best of my knowledge and belief, is true, correct
an mplete as r �uve by I w, and is prepared in accordance with IdC� 64.1•S.S, " eal Property Sales Disclosure Act".
.r���L� n. ,AAnnn ��A.U1:l;l.l��,�(jQ�l,�c`�
�Signa reo(Seller �% /� SignaNreo( Iler % I /� �
n�.,i.l !_r��oflorlmidn � /0.0 / �d�- Starv I (:mttarianrin / / /Y � /�
- APPLfCATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
By�er 1- Name as appeorsom m�veynnre doaument
4984 E. 200 N.
Addres (Num6erand Stree[f
-'�ceton IN 47670
Smre, ond ZIP Lafe
Buyer 2-,Varne os oppeors om m�vryonre documen[
AdJrccs(NumberanJStreetJ
Cit}t Smte, and ZIP Code
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCf10N5 FOR THIS PROPERTY. IDEhTIFY ALL OF THOSE THTT APPLY.
CONDITION
� � 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
2354 W Golumbia Fstates
Addresa (Numberond StreetJ
Princeton IN 47670 Gibson
Ciry, Srnle ZIP Code 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,
induding county:
4984 E.200 N.
Addres (Number orid Stree[J
Princeton,IN 47670 Gibson
City, Sfote Z1P Code Counry
� ❑ 3. Homestead
❑ � 4. Solar Energy Heating/Cooling System
❑ ❑✓ S. Wind Power Device
❑ 0 6. Hydroelectric Power Device
❑ 0 7. Geothermal Energy Heating/Cooling Device
❑ ❑✓ 8. Is [his property a residential rental property?
❑ � 9. Would you like to receive tax statements for [his
propercy via e-mail? (Provide contoct information
belo�v. Please see instructions for more information.
Not available in al! counties.)
Jason D. Pollotk Q( � �II �� / � �l}� • �� , '� � � �o(�
Pnmary pmperry owner ronma nome E-mail
Underpenaltles of perjury, 1 hereby certify that this Sales Disdosure, [o the best of my knowledge and belief, is true, correct
and tomplete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse informaUOn, Social Security and Driver's License/Other numbers are not necessary if no Homestead DeducUon is
being filed.)
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mre o(Bh�er1 Signa[ure oj By�er2/Spouse
" i��,,., n Pollork
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License/ID/O[herNUm6er Number License/7D/OtherNumber