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Homestead_Dodge
C C 4 IN'DIANASA LES DISCLOSURE FORM SDFID SDO 1D 721510 Patel D.PREPARER C Barrett Preparer of the Sales Dtrtlosure Form Title 226 W Broadway Broadway Title, Inc. Address (Number and Street) Company Princeton, IN 47670- _ Cary, Stare, acid ZIP Code Telepnone Number E-mail E.SELLER S GRANTOR S Tammy J Whitsin Sefte,I Nome us nppeun o. mnvewmce document Sellrr2 .vume ns npprors on tonveyuneedorurnrnt 602 N Main St. Address (Number and Brno Address (Number and5tree[) Paloka, IN 47666 - Caty; _ IvA Gq, Swtt,nad ZIP Cade Telr hone Number Email __,�.�- Telr hone Namhe C/ E -mail Under penaltt 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 i/sprepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". .SIgum.re orSeiln 0 SiptuareafSeller r ER(S) G t ES - APPLICATION FOR PROPERTY TAX DEDUCTIONS- NTIFYALLITEMSTHATAPPLY Lawrence J Dodge Patricia A Dotlge . appears nn cum, me dxumen: Buyer2 Nome us np an mnveynnte document bson ibson Address (A'umber and Streeo Address t,Vnmber and Street) Princeton, IN 47670- Princeton, IN 47670 - City. State. and ZIP Coe, e f\ ' Cary. Stale, and ZIP Code Tele hone Number E bit Tele hone Number PAW) THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I CONOIT x❑ ❑ 1. Will this property be the buyer's primary x ead residence? Provide complete address o(primary - 4. Solar Energy Heating /Cooling System residence, including county: E) S. Wind Power Device 602 N MAIN ST. ❑ ❑ 6. Hydroelectric Power Device Address (Number and Street) Patoka, IN 47666 GIBSON ❑ ❑ 7. Geothermal Energy Heating /Cooling Device ❑ © 8. Is this property a residential rental property? City, State ZIF Code County ❑ ❑ 2. Does the buyer have homestead in Indiana to be a 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.) �T/� J /( q'��o -077 '�i <•ot- a[/V .l�s� �/�0 Adders' (Number and Street) City Smm ZIP Code County Pnmarypmperry owner mrmu name Email 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 riled.) �r n ISignatureofBvyeq =Use Sign{a ^tlure o /Rvyerl /Spouse 1r�, n 9 /aQll �9 / ,,fl L+n,07 r�l ii/ �� ( •rte il�uly i 1 /I ft. �J �Vt7� Sl�� Prinwa Legal Name o - Buyerl Sgn On, 66f /DD• Y11 Punted Lryal Name of Buyer 21Spwrse Sign Oatel .4/ /Yym '&; Las[ 5digics of Buyer l Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2 1Spouse Driver's State Last 5 Digits ofSDcial Security License /ID /Other Number Number License /ID /Other Number