Homestead_Norton (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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D.PREPARER- -
Kimberly A. Lewis Office Manager
Preparer of the Sales Disclosure Form Tide
226 W. Broadway Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 kim.blamw.twcbc.com
City,State,and ZIP Code Telephone Number E-mail
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E.SELLERS)/GRANTOR(S)- -_ . ' - . - - - . •
Dennis J Beauchamp lane A Mason
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
138 Palm Coast Parkway NE Box 962 505 Meadowlark Dr
Address(Number and Street) { Address(Number and Street)
Palm Coast Fl 3
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 acc od.ace wit, IC 6-1.1-5.5,"Real Property Sal' Disclosure Act", 0
Signature of 1'erY n (J Su 'cure of elSler ,
QQ.N h 1 S :1 ' ll;e Aa CIL/1 Not a / Z-L - / -/ - �. ✓I 1 Mecca (_- Za—f
Printed Name of Seller Sian Date(MM/DO/MY) • 'aced Name of Seller Sian Date(MM/OD/YYYY)
... F���.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALfEt� PE$,\ ) - -
Christopher M.Norton
veyance document Buyer 2-Name as appears on conveyance document
506 Roosevelt Ave. DEC-3-0 7014
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO C ,
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primal��-ET—D 4.Slat-Erse,g eating/Cooling System
residence,including county: ❑ ❑
417 S Prince St S.Wind Power Device
Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device
Princeton, IN 47670 ❑ ❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana to be 111 ❑ B.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)
016 _/ ,z-o7 - 3o y_ COO. ! Se - o 1. g
City,State ZIP Code County
Primary property own er contact name E-mail