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Homestead_Fromme
INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1793758 Page 2 D.PREPARER - - _ _ _ _ _ _ Kimberly A.Lewis Office Manager Prepares of the Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 kim.bti @mw.twcbc.com City,Store,and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S) _ - - _ - - Brent W.Boehman Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 7358 N SR 65 Address(Number and Street) Address(Number and Street) Hazleton,IN 47640- 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". 81"rnT LA /{et Amdrs Signature of Seller Signature of Seller 0/- . L 4 rfRRlfL� .5r, . .. . • ,. .. :UYER(S)/GRANTEE(S)-APPL ATION FOR PROPERTY TAX DEDUCTIONS-`IDENTIFY ALL ITEMS THAT APPLY - Michael Fromme . wears _,acre document Buyer Name as appears on conveyance document j., 4835 d0UW RR// 111 Address(Number and Street) Address(Number and Street) Jasper, YES NO CONDITION 3 NO CONDITION COO, © ❑ 1.Will this property be the buyer's primary © ❑ 3. Homestead Pj' •1(0.,. residence? Provide complete address of primary r�•ia�sr. ergy Heating/Cooling Systrffto residence,including county: ❑ © /� 7358 N SR 65 5.Wind Power Device Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device Hazleton,IN 47640 GIBBON ❑ © 7.Geothermal Energy Heating/Cooling Device City State ZIP Code County ❑ )0 2.Does the buyer have a homestead in Indiana to be ❑ © 8.Is this property a residential rental property? 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.) Address(.VUmber and Street) �( City State ZIP Code County ��—&-lX -alai-op .��- o / 2 Primary property owner contact name E-mail