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_INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Jerry D. Stilwell Attorney
Preparer of the Sales Disclosure Form Title
3402 N. Prince Street Bamberger Foreman Oswald&Hahn
Address(Number and Street) Company
Princeton, IN 47670 812-386-6482
City,State,and ZIP Code Telephone Number E-mail
'ErSELLERSS]/GRANTOR(S)-.' -`,1.". :. . , � .. •" . .,- ... _ . ..
Charles V Fullerton
Seller I.Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2467 E 600 S
Address(Number and Street) Address(Number and Street)
Ft Branch IN 47648
Telephone Number E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and 1 as required bi .- -nd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
9"(gnature of Seller ' - Signature of Seller I
Charles V Fullerton (--2—ag-ITh
Printed Name of Seller Sign Date(MM/DD/rrYt) Printed Name of Seller Sian Date(MM/DD/ Yi)
F.BUYER(SJ[GRANTEE(S) APPLICATION FOR-PROPERTY:FAX•
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES _10 CQNDITION
0 ❑ 1.Will this property be the buyer's primary CS ❑ 3.Homestea
residence? Provide complete address of primary n n 4.Solar Energy Heating/Cooling System
residence,including county: ❑
S.Wind Power Device
Address(Number and Street) ❑ N 6.Hydroelectric Power Device
City, ZIP Code County El N 7.Geothermal Energy Heating/Cooling Device
El IS 2.Does the buyer have a homestead in Indiana to be n 0 6.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Si 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: belo • . '• dons for more information.
Not available in all counties.)
Address(Number and Street)
t, -/9- 09 - woo _ cot. (a85 - ozS
City.State ZIP Code County
• •rtv owner contact name E-mail