Homestead_Richardt<
'INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
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Karen Harbison VP
Repvrer o(Ne Sala D"udosure Form Title
803 E State Rd 6S Haubstadi Siate Bank
Address (Num6er and SveetJ Company
Haubstadt IN 47639 872-768-5800 kharbison(o�esbanc.com
Ciry, Smt4 and ZIP Lade Telephane Number E-mail
;E.'SEI!I:ER S GRANTbR S - ' "� t :F�d w �.�� �a=�� �-a:r��_ ��x;��_+.�t9��.�_� ;-
Brandy M Rirhardt former�y known as Rrandy M Peek
Seller 1- Name as appears on tonveyance daument Seller 2- Name os appmrs w ronveyanre dacumen:
45A S 1S0 E
Addr¢s (Number and SveetJ Add�ess (Num6er and Stree[J
Prin�aton IN 47670
Tele honeNumber E�mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to [he best of my knowledge and belief, is [rue, correct
and complete as required by la�v, and is prepared in accordance �vi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[".
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S'gna2re o(SMIe SignoNre o(Seller
Bran M Richardt fka Brandv M Peek 02/07/2073
Pnn[edNameo/Seller SianDa:e MM/00 PnntedNameo Seller SianDare MM/OU
�.F.�BUYER S ` GRANTEE S � APPLICATION:EOR=PROPERT�Y_�TAXiDEDUCTIONS�IDENTIFY?AL'L'+ITEMS6TH�T�AP,PL'Y_:_.�:,������;;
e M Richardi Brandy M Richardt
�� .eyoncedocvment Bvyrrl�Nameasappearsonronveyanmdocvmrn[
358 S 780 E 358 S 780 E
Addrus (NUmberand Street) Address (A'vmberand Sveet)
Princeron IN 47670 Princeton IN 47670
Tele honeNumber E-mail
THE SdLFS DISCLOSURH FORM MAY BE USED TO APPLY FOR CERTd18 DEDURIOYS FOR THIS PROPERTY. IDEhTIFY ALL OF THOSE THAT APPLV.
1'ES 60 CONDITIOA I 1
Q ❑ 1.1Nill [his property be the buyer's primary � ❑ 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Hea[ing/Cooling System
residence, including county:
'�FA S �RO E ❑ ❑✓ 5. 4Vind Power Devire
Addrus(Numbuand50-ee[) ❑ 0 6. Hydroelectric Power Device
Princeton IN 47670 � � 7. Geothermal Energy Hea(ing/Cooling Deviw
Ciry, Smre ZIPCode Caunry.
� � 2. Does [he buyer have a homestead in Indiana [o be � � $� �s [his property a residential rental property?
vaca[ed for this residence? If yes, provide ❑ � 9. Would you like ro receive [ax sta[ements For [his
complete address of residence being vacated, property via e-mail? (Provide conCact informotion
includingcoung�: lease_S einstructionsformorein%rmation.
No[ available in all counties.
Addrae (Number and Streel) /
� a� -��_oq _3o0 -ooy, o�.�.-aa�
liry, Smte ZIP lade lovnry
Pdmary Properry owner ronmat name E-mail
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