Homestead_Vaal (2) INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1800727 Paget •D.PREPARER_-_ - _._ - - - Kimberly A.Lewis Office Manager Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title Inc. Address(Number and Streer) Company Princeton,IN 47670- 812-386-1687 kim.bti @mw.twcbc.com City.State.and ZIP Code Telephone Number E-mail E.SELLERS)/GRANTOR(S) - _ - •. Ryan Deal Seller 1-Name as appears on conveyance document Seller Z-Name as appears an conveyance document 7099 St.Rd.68 Address(Number and Street) Address(Number and Street) Elberfeld,IN 47613- City.State,and ZIPCode City.Store,and VI'C-ode u elephone Number E-mail Telephone Number E-mail 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,an is prepa ed in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". I zN Signa:ure vf5eger Signature of Seller 2 2 u l y il >)(6„ il,'VW' Pd.W N.-. er4+p s:..rM.a IP•• ,nmm. Par d,r- .r s., On-Mrr v /wry. F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT A/'.•' . Jeremy Vaal _ r j Buyer I-Name as appears an conveyance document Buyer?-Name as appears on converance document / 216 Vme St. r - Address(NumberandStreet) Address(Number and Street) rok - at Haubstadt,IN 47639- Y 1 o 494 City,Stole.and ZIP code City,Stale,and ZIP Code Q la - yy9 eISY9 ��esn Telephone Number E-mail Telephone Number Cbti Smvi/ THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE.THAT APPLY. —4/� YES NO CONDITION I YES NO CONDITION ,�Y/Ak//2fT © ❑ 1.Will this property be the buyer's primary © ❑ 3. Homestead Of? residence? Provide complete address of primary Li ❑ 4.Solar Energy Heating/Cooling System residence,including county: El 203 N.WEST ST. S.Wind Power Device Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device Haubstadt,IN 47639 GIBSON , ❑ © 7.Geothermal Energy Heating/Cooling Device City,Stale 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(Number and Street) �/ /O ' /� 33 v/Ju/7-- O"y' `/yDa �. / -DDS' City,State ZIP Code County Primary property owner contact name E-mail 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".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed.)I�� Si .ntur- fluyerl Signature ofBuyer2/Spouse TLeg lNo j uyerI 11-1— 1'-1 Primed Legal No eof Buyer I Sign Date(MAIMO/YM1 Printed Legal,Name of Buyer 2/Spouse Sign Date Dw/o0/m11 (Q alt-10 IN 9 .alq`7a Lost 5 digits of Buyer l Driver's State Lust 5 Digits of Social Security Number Lust 5 digits of Buyer 2/5 poow Driver's Rule Lust 5 Digits of Social Security License/ID/Other Number Number License/ID/Other Number