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Homestead_Frederick (2)
INDIANA SALES DISCLOSURE FORM SDP ID SDO ID 1786873 Paget •D.P,REPARER'.-:. :-_ .- Kimberly A.Lewis Office Manager Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 kim.bli @rmv.twcbc.com City,State,and ZIPCode Telephone Number E-mail •E:SEcLER(S)%GRANTOR(S):.t-. • . - : ..-. _ : - . ."-:. •-g-.,L' : . : - . "...C-.1 Merlin F.Collins Jr. Vivian Rose Collins Seller I•Name as appears on conveyance document Seller 2-Name as appears an conveyance document 2109 N.Carithers Rd. 2109 N.Carithers Rd. Address(Number and Street) Address(Number and Street) Princeton,IN 47670- _ . __ Princeton,IN 47670- Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complet as equ/ipr/ed /law,and is grepared in accordance with IC ,1.1-5.5,"Real Property Sal-,_-,_47---,s Disclosure Act". ",'�"y,,/�/ ant? /�d�1 ////L tto-- � Signature)o�f,eller I Signam of Seller A1EK O./ %C. Cate,,✓ ,c,JK 0/7/pi' r l a /, ',�_os- —f Primed Pb'",'rrcdler cp...,one,„„mnnvn, Print p4 Nnne,JGyrrr Clan Dare nu„nanvyn - - - - f.;BUYER(S)%GRANTEE{S)=APPLICATION FOR PROPERTY.TAX DEDUCTIONS='IDE1 TIFY ALL-ITEMS THAT_APPLY'--'' ..'_ -., Charles M.Frederick II Buyer I-Name as appears on conveyance document Byer 2-Nome as appears on conveyance document 306 Crestview Dr. Address(Number and Street) Address(Number and Street) Owensville,IN 47665 THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION 11.-) Q ❑ 1.Will this property be the buyer's primary © ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heatin Co a -4t residence,including county: ❑ © S.Wind Power Device 2109 N.CARITHERS RD. EN 8 2014 Address(Number and Street) El 6.Hydroelectric Power DeviEA Princeton,IN 47670 GIBBON ❑ © 7.Geothermal Energy Heatin• Coolin• De - City.State ZIP Code County • I 11 ❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ © 8.Is this property a residen �I,y,-t ijir"7Ft n?lT vacated for this residence? If yes,provide ❑ ❑ 9.Would you like to iyeN) 2ftkgth�Kts�rtn PR 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.) Address(Number and Street) t City.State ZIP Code County - 5-33 lop - 3.99 - -6 a s Primary property owner contact name E-mail