Homestead_Collins (8)I�DIAN,\ SALES DISCLOSURE FOR�I SDF ID SDO ID 138fi870 Page 2
�D.�PREPARER`-. � �z..--: � '-�i - '�a "2`: - ` _
KimbedyA. Lewis Office Manager
Papure�ofNeSalesDiulosureFoim l5tle
226 W. Broadway Broadway Title, Inc.
Address (Nvmber and Street) Company
Princeton, IN 47670-
-E.SELCER S -GRi1NTOR S . .''..: .- � - •. .. � •--. e .-_ - .. .� -...... _ .. ••�:•--
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Sandra L. Kolb
Seller 1- Nome os e?pvn an rortve�vnce dorumrn[ SeRerZ - Nomr us op�xvrs on mrt�•p'una Oavment
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Addres (NUmDv and Svret) AAdress (,Yumber andSReet)
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AnneNUmber E�mall
Under penalties of perjury, 1 hereby certity [hat this Sales Disdosure, [o the bes[ of my knowledge and belief, is [rue, correc[
and co I�9uired by la , and is prepared in actordance with IC 6-1.1•5.5, "Real Property Sales Disclosure Act".
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SignamreoJSeller SignvNreofSeller
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E: BUYER S GRANTEE S=APPLICATION EOR PROPERT.YTAX DEDUCTIO�S=IDENTIFYAbL ITEMS THAT APPLY.: .
Harold W. Collins KimbeAy A. Coilins
Buyo 1� Nvme as appevrs om m�ve}ance docvmene duyer 2- Name asappearsom m�veyanceQwumm[
560 E. Old Petersburg Rd. 560 E. Old Pelersburg Rd.
Addre.a(Numberond5[ree[) Address(Abmbe�and5lrc<Q
Princeton, IN 47670- Princeton, IN 47670-
Ciry, Smtr, and ZIPCOde Clry, Sm[r, and 21PCode
�E'�mail �fde F.oneFUmber � �maJ
TXE SAI.ES OISCLOSIIRE FORM h1AY BE USED TO APPLY FOP CERTAIN DEDURIOYS FOfl TNIS PROPERTV. IDEhTIFY ALL OF THOSE THAT APPLY.
\'FS NO COXUITION (
�x �. 1. Will this property he the buyer's primary x � 3. Homeste
residence? Provide complete address of primary � 4. Solar Energy Heating/Cooling System
residence, including county: � �
676 E. TAFT TOVJN RD. S. Wind Power Device
Address(A'umberandSaeeQ ❑ Q 6. Hydroelectric Power Device
Princeton, IN a7670 GBSON � � 7, Geothermal Energy Heatlng/Cooling Device
Ciry.SmteZiP[aLr [aurtry
�� 2. Does Ihe buyer have a homes[cad in Indiana to be � � 8. Is this property a residential rental proper[y?
vacated for this residence? If yes, provide ❑ � 9. N'ould you like to receive [ax statements for this
comple[e address of residence heing vacated, property via e-mail? (Provide contact information
including coun below. Please see instrucdons for more informafion.
s� ��' �� ������� �� Not avuiluble in ull counties.)
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Under penaldes of perjury, I hereby certify that this Sales Disclosure, m[he hes[ of my kno�vledge and helief, is irue, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[". (Note:
Spouse information, Social5ecurity and Driver's License/Other numbers are no[ necessary if no Homes[ead Deduc[ion is
being led.) � �
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