Homestead_Sherman1\DIA\ASALESDISCLOSUREF'OR\t SDFID SDOID 1386688 Page2
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KimheAyA. Lewis Office Manager
Prtyomro([he5aler�utlasure£orm 75t/e
226 W. Broadvray Broad'way TOe, Inc.
AdAress (NUmbonnASnret) Compony
Princeton, IN 47670-
'E.'$E�GER S GR�INTOR $ � :r' ��' .» ��`_..�:�., - �._�.r . -.�r, :��.�; ��,t=r�, r�: �- w � - r . � �.. ,.�� '..
David E. Ruckman
Sel7er7 - Nume as eppevrs on mmreyvnce dorumen[ SMh� 2- Nume os appeurs am m�vrynnce Javmm[
P.O. Box 61
A6drets (NUmber and StreetJ AAdress (Numberand Stree�)
Franpsco, IN 47649-
Ciry.Smlc. vndZIPCoCe City.Smte, andZlPGoAe
E-ma17 iele honeNumber E�moll
Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, [o [he best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in acmrdance �vi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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:E:BUYERS GRANTEES =APPLIGATION.:EORP-ROPERTY,TAXDEDUBTIONS'_IDENTIFY•ALGITEMS'THATAPPLY F. r-�;<
Russell W. Shertnan
Buyei I- Name as oppevrs on ronveyonre docvment Buysr7 � A'ame us appears om m�veynnre dotummt
New York St.
Addrns(NumberandSbeetf Addror(Num6erandStrzeQ
Hazleton, IN 47640.
Ciry, Smte and "LIPCode Ciry, Sm[e, and ZIP Code
6'�mail Trle honeNurn6er E�mnll
TNE S,1LE5 DISCLOSIIRE FORM h1AY BE USED TO APPLI' FOR CERTAIN DEDUCf10Y5 FOR THIS PROPERiV. IOE�TIFY ALL OF TNOSE THAT APPLY.
YFS NO CONDITION I ���3 NO CONDITIOY
x� � i. Will this properry be the buyer's primary Qx ❑ 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling System
residence, intluding county: � �
114 TENNESSEE ST. S. Wind Po�ver Device
Address(NUmbrrandSVeN] ❑ Q 6. Hydroelectric Power Device
Hazleton, IN a7640 GIBSON � � y, Geo[hermal Energy Heating/Cooling Device
Ciry. Smte Z!P LoCe Counry
�� 2. Does the buyer have a homestead in Indiana m bc � 0 S. ls this property a residential rental property?
vacated for this residence? If yes, provide ❑ � 9. Would you like to receive tax s[atemen[s for this
complete address of residence heing vacated, property via e-mail? (Provide conmct information
including county: below. Please see instrucdons for more in%rmation.
Not uvailable in ull caunties.)
Addren (NUmberaMSUrerJ
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Ciry.SmCeZIPCode Lbunry -��
Pdmaryproputymmermnmcrneme E�mnil
Under penalties of perjury, 1 hereby certify that this Sales Disdosure, to [he bes[ of my knowiedge and belief, is true, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-11-5.5, "Real Property Sales Disclosure Act". (NOte:
Spouse information, Social Security and Driver's License/O[her numbers are not necessary if no Homestead Deducdon is
being filed.)
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