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Homestead_Walker SALES DISCLOSURE FORD SDF ID SDO ID 1791911 Paget :EPARER 'rmantha Culsinger Preparer of the Sales Disclosure Form Tide 226 W.Broadway Broadway Title,Inc. /' Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 Samantha.btit @mw.twcbc.com Cy.Scott and ZIP rode Telephone.Number E-mail E.SELLER(S)/GR,4NTOR(S) Carolyn D Leible Seller I-Name as appears on tomnvn.e document Seller 2-Name as appears on Conveyance document 907 Chickasaw Dr. Address(Number and Street) Address(Number and Street) Ft.Branch,IN 47648- 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". Signature diSeller Signature of Seller CAnc��lPQ LEi 1E. ,SILIl'r P.:...od N^cop p r crib," c;,-,@.rpeM 4 1I',yWw PdY+d Pmmedcep.r cr.n nnmt4L^,P'MY, F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- 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 t © ❑ I.Will this property be the buyer's primary © ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy dal/ till residence,including county: ❑ © S.Wind Power Device 907 CHICKASAW DR. Address(Number and Street) ❑ © 6. Hydroelectric Po iAM Ag e Jk5 2014 Ft.Branch,IN 47648 GIBSON ❑ ❑ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County , © ❑ 2.Does the buyer have a homestead in Indiana to be ❑ © 8. Is this property . ;;'�, pq rt property? vacated for this residence? If yes,provide ❑ ❑ 9.Would yoGISSOpt y ttttorp tkr this complete address of residence being vacated, property via e-mail?(Provide contact Information including county: below.Please see instructions for more information. 607 E.LOCUST ST. Not available in all counties.) Address(Nunt her and Street) /� 1, Ft.Branch,IN 47648 GIBSON ,-,/&-I q-I g-I O I- o Dl. 1 '1 E-6)) , City,State ZIP Code County t! Primary property owner contact name Email