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Homestead_Whitehead
C 4 :J INDIANASALES DISCLOSURE FOR ?I SDF ID SDO ID 934149 Paget D.PREPARER _ Samantha Cutsinger Preparer ofthe Sales Disclosure Farm. Tare 226 W. Broadway Broadway Title, Inc. Address (Number and SVeet) Ca.•npany Princeton, IN 47670- Opt State, and ZIP Code Tetephone Number E -mail E. SELLER(S)/GRANTOR(S) John P Davis Jr Melissa R Davis SellerI - Name as appears ancuav,ence document Seller 2 -Name as upymo -on ccm oevu ce dortmrel P.O. Box 46 P.O. Box 46 Adams (Number and Street) Address (Number and Street) VAnslow, IN 47598 - VVlnslow, IN 47598 - Cip', Store. andZlPCode / J,f Gry, State. and ZIP Code f% /V //-}- IV14 Tel, hone Number E -mail Tel, one Number E -mall Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and c pI e s required by law, and is prepared in accordance �wit,�h1 IC 6- 1.1/j-5.5, "Real Propert ales Disclosure Act ". R �,J . I L L' 4A A,A n I ,,L,) Signor eafSell SignanFFFe ofSelier 7 �,,, �. W. Da V l"s & -a9 acts F. BUYERS GRANTEES - APPLICATION FORPROPERTYTAXDEDUCTIONS- IDENTIFYALLITEMSTHATAPPLYr Shannel R Whitehead Buyer 1 - Name as appears an conveyance dotumenc Buyer Z - Name as appears on ronvevaare document 530 S. Hall St. Addrsss(Abmbsrnnd Street) Address (Number, and Street) Princeton, IN 47670 - Cary. State. and ZIP Code City. State, and ZIP Code Tnl,Phone Number Email Tel, hone 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 ITS NO CONDITION x ❑ 1. Will this property be the buyer's primary ❑ Q ❑ 3. Homestead residence? Provide complete address of primary ❑ © 4. Solar Energy Cleating /Cooling System residence, including county: ❑ S. Wind Power Device 7051 E a50 N ❑ © 6. Hydroelectric Power Device Address (Number and Street) Francisco, IN 47649 GIBSON ❑ © 7. Geothermal Energy Heating/Cooling Device ❑ © 8. Is this property a residential rental property? City, State ZIP Code County E] C] 2. Does the buyer have a homestead in Indiana to be vacated for this residence? If yes, provide ❑ © 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: below. Please see instructions for more information. Not available in all counties.) alo -off -cg o aoo ao3 o /3oi7 Address (Number and Street) Cary, State ZIP Code County Primary Peaaerry owno rormR name 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 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 bei riled.) iZ& l /a M .xn � • Aature ofBUyerl Signature u /Bvyer7 15pouse ou kz, n rw J�i. >IFAPC w 6-„24 -42 Last 5 digia of Buyer l Driver's Stare Last 5 Digits of Social Security Number Last 5 digits ofBuyer2 /Spouse Driver's State Last 5 Digits ofSocicl Security License /ID /Other Number Number License /ID /Other Number J