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INDIANASALHSDISCLOSUREfORN SDFID SDOID 930705 Pa�e2
��D: P,REPARER'€..�'K.* �.,v.��,J. ._�3��,%s�x°'.s'a�,?.�?�'+' � . ,r.n.y:�.?t�'#_'3:z°��?:'.-.��.'rt'��}�k�T�''^vi.��a.��,dr�z'�;'�.',7}t... ��,:¢' ..a''. .,h.�et?S
�C Barrett
Preparer ofthe Sales Dlsdosure Farm 7YJe
226 W Broadway Broadway Ttle, Inc.
.lddress (hLmM andStrcetJ Camyony
Princeton, IN 47670.
'E:SEI:I:ER S' GRANTOR S '-�i �'t�.t:_ � _. t � _�:.z.;�Fe, -�"3f,,..�:;'.:." �.i.�•;�¢ -�.� _`+- ; ;.-��?-..
Fem R. Woods bY JudY W. Puckett POA .ludith W. Puckett
Selier ]- Name ar appears am m�vryvna docummt Selfer 2- Name as appears m rwrveynnce Eocument
5051 5051 Chatham Valley
Address(NumOeraMSuce�) AdQrtu(NumbrrorMS[rret)
Chatham Valley, OH 43675- Toledo, OH 43615
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Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the bes[ of my knowledge and belief, is hve, correct
a�r d complete nas, �equired by la�X, and is prep�red in accordance with-tC 6•1.t•5.5, "Real Pr perty Sal/eLs Disclosure Act".
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SignatureoJSe r -�c��;� /.� �S�numreo(Sd(rt %
Fern �'Woods l�- �-D�� �udith W. Puckett �7/�Z�10!
::FiBUYER S � GRANTEE S �.=APPLIGATION=EOR P.ROPERT�1'aTAX?DEDUCTIONS=,IDENTIEY�ALI:ITEMS�.THATAPPLY�: �L� { '�- -
Ronald J. Stalker Judith L. Stalker
Buyer 1� Name os appearson convrynnre doaument Bvyer 2� Name as aypma on tonvtyance dxummt
1814 15N SVeet 1814 151h Streel
AEEr¢s (NUmbe� andStrerQ Address (NUmber onG Sveea)
Bedford,IN 47421- Bedford,IN 47421-
Email Tele 1wrteNumbo Email
TNE 5.1LF5 DISCLOSIIRE FORM MAY BE USEO TO.IPPLY FOR CERTAIY OEDURIONS FOR THIS PROPERTY. IDENfIFY ALL OF TNOSE THAT APPLY.
YES NO COYDITIOY I YES NO CONDITIOY
Q � 1. Will this properry be ihe huyer's primary ❑x ❑ 3. Homestead
residence? Provide complete address of primary � Q 4. Solar Energy Heating/Cooling System
residence, including county:
1608 TAYLOR AVE ❑ Q 5. Wind Power Device
Addreu(.YUm6erand5urrt) ❑ Q 6. Hydroelectric Power Device
Princeton, IN a7670 NOTAPPUCABLE � � 7. Geo[hermal Energy Hea[ing/Cooling Device
Ciry.SrureZlPCode eo���.
��] 2. Does the buyer have a homestead in Indiana to be � 0 8� �s this property a residential rental propem•?
��acated For this residence? If yes, provide ❑ � 9� Would you like to receive tax statements Cor this
complete address of residence being vacated, property via e-mail? (Provide contact informotlon
induding counry: 6elav. Please see instrucdons(or more rnformation.
Nor availa6le in a(I counties.)
Address (NUmber ond Slrret) (`�
Ciry,Sm[eZfP[ode Caunry ��_l� -O� •zd3 ad33..3Q 0�6
PtlmarypmPrrtyawnermnmc:name E-maif
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best o(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 Proper[y Sales Disclosure Act". (hote:
Spouse informatlon, Social5ecurity and Driver's �Li nse/Other numbers are not necessary if no Homestead Deduction is
being fil�6:r1 � S11�%�2��`"-�., ( J ` �
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