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HomeMy WebLinkAboutHomestead_Bradshaw (3) INDIANA SALES DISCLOSURE:FORM SUE ID Soo 10 1797457 Page 2 a PREPARER \ Bryceann Cutsinger Preparer of the Salo Disclosure Form Tide 226 W.Broadway Broadway Title.Inc. Add.r..(Number and Su net) Co/"parry Princeton,IN 47670- _ 812-386-1687 samantha.bti@mw.twcbc.com Gtv.State.and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S) Jeremy Blankenberger Seller I•Name a uppeon un Conn-mote document Seller-2-Puma 01 uppeem on runt-gamma document 605 S.Center St. Address(Number and Street) Address(Number and Street) Ft.Branch,IN 47648- Under naltie o perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and plete s e.uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". 4, er. ofn�`1��r,; .S'ipnanue of Seller ,ef1�IT\ Ste.-.nett- G/ ORI(' ZL:(L- .eA+:n -,'erlr. rf ci,- o n Pn" 4 1:nme al c•lr=r gin,n-re,. -,"./srm F. t• `• Y• EE(S)-APPLICATION FOR PROPERTY TAX DED VS- IDE Y ALL ITEMS THAT APPLY (Eric A.Bradshaw Jennifer Naas inn-n Buyrrl-N'o,n .,pp.-ors nnry rvrrvnce J,x'urnent once document 2t . - view 9650 5.450 W. Address ranch,IN 47648-Area!/ Address na,IN and Street)2- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS ''•' . r . . .F THOSE THAT APPLY. YES NO CONDITION � YES' NO CONDITION �n/ © ❑ I.Will this property be the buyer's primary � © U 3.H...-- . �f;; qG // residence? Provide complete address of primary • a , oar Energy IFeatttrig7uo lPrtt YerPUDITOR residence,including county: ❑ gi 605 S.CENTER ST. 5.Wind Power Device Address(Number and Street) ❑ © 6.Hydroelectric Power Device Ft.Branch,IN 47648 NOT APPLICABLE ❑ © 7.Geothermal Energy Heating/Cooling Device - Cirs'.State ZIP Code County ❑ ❑ 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(Number and Street) 07 —/9/9—/a/-cop. o m4 City.State ZIP Cole County Primary property owner contort name B-mad