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Homestead_Flickr� f ' I\DIA�ASALES DISCLOSURF. FOR\I SDFID SDO ID 934301 Page 2 D.PREPARER Samantha Culsirger Aepare� aJohe Scfo Disdorvre Form Titlr 226 W. Broativ2y Broatlway Title, Inc. nad�o,lx�mrx.o�ew��n7 tomPO�y Princemn, IN 47670. E. SELLER S GRANTOR S Louwanna J Jines 7onia L Hedge Seller 1� Nome vs apyevn on �onveylm<e da'ummt Srllrr 1� Nume as uFi+ro^ �m m�.eyunie da'umrn! 627 E. Brumfield Ave. 627 E. Brumfield Ave. ASdrm (Nvmber ond StnrQ AdErrss (Number anCSTeec/ Princeton, IN 47674 Princeton, IN 47674 Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correc[ an�dp complere as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". dec�wa..�.s.Q 4��-w+-�J ��3"t�U�C. �; dl � nD„ � Signamreo(5� Si,qnaomrafSeller �ouwn-h ne T. Tinec 7_ zo-aa�a �'�, • 7-ap- a, � F.BUYER S GRAYTEE S -APPLICATIONFORPROPERTYTAXDEDUCTIONS-.IDENTIFYALLITEMSTHATAPPLY Sandra L FliCk Buye� 1- Rame ns vppears nn conveyanre daavment Buyer? � Nomr us apAeors an:anveynnre daoument 165 Division 5�. ACdress(Nvm.bermd5treet/ AOErat�,YUmberandSneet) Grand Rivers. KY 42045 Ciry.S:a¢. ond ZIPCaEe Ciry. SmR. and ZIP CoOe -� ` Emoil TUr honeA'umber £�mail TNE SALES OISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDURIONS FOR THI$ PROPERTY. IDENTIFY ALL Of THOSE Tt1AT APPLY. 1'ES YO CO�OITION 5'FS NO CONUITIOY Q ❑ 1. Will this property be the buyer's primary ❑x ❑ 3. Homestead residence? Provide complete address of primary � � 4. Solar Gnergy Hea[ing/Cooling Sys[em residence,indudingmunry: ❑ � 627 E. BRUMFIELDAVE. 5. �Vind Power DeviCe Address(Numhrrond5v�ev) ❑ Q 6. Hydroelectric Power Device Princelon, IN 47670 NOTAPPUCABLE � � �, Geothermal F.ne�gy Heating�Cooling Device Ciry. Sm:e ZIP CaCe Counry ��] 2. Does Ihe buyer have a homestead in Indiana m be � Q $� �s this property a residential rental property? vacated for this residence? If yes, provide ❑ Q 9� �Vould you like ro receive tax statements for this complete address oF residence being vacated, properry via e-mail? (Provide conmcr informotion induding munty: be(ow. Pleose see instructions%r more information. Not avai/ab(e in a!I counties.) Addrm (A'um.Aer ar.dSUret) n? Io -l� -O-]��J y OQa � l� Ciry.SmreZlPlode Counry I'rlmarypmperry o�mo rontavt nvme 6'-mail Under penalties o(perjury, I hereby cer[ify that this Sales Disdosure, to the 6est of my knowledge and belie(, is [rue, correct and complete as required by law, and is prepared in accordance with IC 6d1-5.5, "Real Property Sales Uisclosure Ac[". (Note: Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deducrion is being fled.) anireofBVVerI ��1� 9gna�ureofBvyer7/Spovse � =t�ci� � a�� i�- LastSdigicso(B�rymr2/SpauseD�ver's Sm[e LastSDigiuo(Sacicl5ecunry License/ID/Othe�Number T'um6er Lirense/ID/0`herNumber