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Homestead_Hanks
INDIANA SALES DISCLOSURE FORM SDF ID 590 ID 1769129 Page2 D.PREPARER Samantha L Cutsinger Preparer of the Sales Disclosure Form Tick 226 W.Broadway Broadway Title.Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 broadwaytitlel @insightbb.com Dd.State.and ZIP Code Telephone Number Email E.SELLER(S)/GRANTOR(S) Jerry D Scott JP.. Seller I-Name as appears an Lowest:me dame men: .Silk,Z-Name as appear.action i n anee document 384 E 850 North Address(Number and Street) Address(Number and Street) Hazleton,IN 47640- Telephone Number Email Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and Ade co • .fete •- equi ` by law,an s prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". c Sir .n art•,Seller Signature of Seller J2rr�� .Scprir 2. % -.2s /3 Pna.M Na Si..n rural vV•m•srvtt Pri"rn5 yam.nr sot.. .�•• rrva/n•vvvM F.BUYERS)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY ((Adrian Hanks biped n'ume as appears an n-ann}vnre document Buyer 2-Name is appears on Conveyance document 831 W.Wood St. Address(Number and Street) Address(Number and Street) Princeton,IN 47670- Telephone Number Email THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION © ❑ 1.Will this property be the buyer's primary © I 3. Homestead residence? Provide complete address of primary 4.So ar Energy Ileati yst - residence,including county: 384E 850 NORTH ❑ © 5.Wind Power Device Address(Number and Street) ❑ ❑ 6. Hydroelectric Pow r evice Hazleton,IN 47640 GIBSON ❑ © 7.Geothermal Energy Fleati Co ting,fle Ice Cm,State ZIP Code County 4 %Ill'! ❑ © 8. Is this property a residential re' 2.Does the buyer have a homestead in Indiana to be al p op rty? vacated for this residence? If yes,provide ❑ ❑ 9.Would you like to receive iie state .en for • complete address of residence being vacated, property via e-mail?(Pr.rjf;t;r r.-«„/fjio; motion including county: below.Please see 3+08Gwl. 4 . •iotigimertm- - 831 W. Wood St. I• "L7:L.AI (ar.dl r_ to Address(Number and.Street) Princeton , IN 47670 Gibson _ 26 _04 -sg . pis- 000•"34o ,Z _o/F City,State ZIP Code County -" \ t•mvner roruartnume E' .d Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of 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 Property Sales Disclosure Act".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is beiq filed.) l/ Number License/ID/Other Number