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INDIANA SALES DISCLOSURE FORM SDF ID Pa eg ,
.D:'.PREPARER '_._ _ - ,D-f. "_:- _ _ _ _ _ , t.;. -- - ----v ��_- - �. _, . ._ • ilf,
SHERI L GREENE
Preparer of the Sales Disclosure Form Title
1122 E OHIO ST
Address(Number and Street) Company
PRINCETON, IN 47670 812-664-1005
City,State,and ZIP Cade Telephone Number I E-mail
EYSELLER(S)/GRANTOR(5)',1,_ p.- :. - , . ___.�. .�.,_ _ ._ ,,-•=r-a_l=r- .. :- _ S'- — - _.
SHARON A Fl I IOTT
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
8930 N CUNNINGHAM RD
Address(Number and Street) Address(Number and Street)
HA71 ETON IN 47640
Telephone Number I E-mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co p to as required by law,and is e ared in accordance with IC 6-1.1-5.5,"Real Prope rty Sales Disclosure Act".
I
..tiateller Signature of-Seller
SHARON A Fl LIOTT,, 07/ S /7013
Print of Seller ■ Sign Date(MN/DD/11111 Printed Name a/Seller I Sian Date(MM/DD/YZYY)
F-BGYER(S)/GRANTEE( )=.AP,PLICATION•FOR•PROPERTY-TAX DEDUCTIONS=IDENTIFY'ALbilTEMS!THAT?APPLY-,; - :"').--'
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ARED BIRCH MICHELLE BIRCH I
Buyer 1-Name asappea nconveyancedxument Buyer 2-Name as appears o. onveyancedocument
O T I
Address(Number and Street) Address(Number and Street)
HAZLETON. IN 47640 HAZLETON IN 47640
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY'ALL OF THOSE THAT APPLY.
YES NO CONDITION Y CONDITION
0 ❑ 1.Will this property be the buyer's primary Q ❑ 3. Homestead y �
residence? Provide complete address of primary --4-.-Solar E HeI t C I S
residence,including county: "-5.Wind Power Devi
305 S VINE ST ❑ I
Address(Number and Street) ❑ 0 6.Hydroelectric Power getj1C1 5 Z013
HAZLETON,IN 47640 GIBSON ❑ Q 7.Geothermal Energy Heating ooling Device
City.State ZIPCode County
❑ Z 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a resid tits)re al Fty.
vacated for this residence? If yes,provide ❑ Q 9.Would you like to rec is for this
complete address of residence being vacated, property via e-thaBSPH)CalibadchWagrPFon
including county: below. Please see instructions for more information.
Not available in all counties.) A.�
Address(Number and Street) I 0. ry //}
��-0a -.sq-o 2 r Qo o (7
City,State ZIP Code County
Primary property owner contact name I E-mail