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Homestead_Brooks INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1804620 Page 2 LD:•PREPARE-R7S77'.:ciTi.,:711-7-177 r' i'r;:' .-7---"IgLIThl-17.7"3----1-;& :c'.1::—.;T:.....:_:, .7.7' .5-4.,_-_-:-__ t:::317“'.' ,..r.... r:_ .."7"" L ii-J•--. 7: :-. Samantha Cutsinger Preparer of the Sales Disclosure Form Tide 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Fampony Rinceton,IN 47670- 812-386-1687 samantha.bti©mwAwcbc.com City,State,and ZIP Code Telephone Number E-mail 'CS ELLE R(S)/D RA NTOR(S)7:si:Zi' 1 trAg.1.1-r.a.:;71C,. _'bit_. :im,:1": ...?'::::-7.:•I:TT:Li"5..EL t:_ ..::17„:7,14Z-F i":---17_-nt. :;.7.:: 11 7-7.. Dada J Barrett Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 9448 W.650 S Address(Number and Street) Address(Number and Street) Owensville,IN 47665- • Under penalties of perjury,thereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct an 3-comple,/1 e as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". 11. ' A t _te. .-.:._,. e.t.d._ AL_ Signature of Sells A _ . Signature of Seller Dh.14-ie ' J . )04/eke rr 3-2 -l3 Pri-twi ko el'Sena r Sinn Ors.(vu•on nwn ork-p-iren—ncrpuor c,,...,rfr.e„.s,fif/rIntylfra :F:BUYE F4S)/GRANTE MICA Pal GATI ONIFOFt;PROPERTY TAX7DEDUCTION5±',IDENTI FYZAWITEMS}THATTAP PLY JR 5:4:---11::?“:77: Teresa B Brooks Buyer)-Name as appears on conveyance document Buyer 2-Nome as appears on conveyance document 405 N.3rd St. Address(Number and Street) Address(Number.and Street) Owensville,IN 47665- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY YES NO CONDITION YES NO CONDITION MAR 1 8 2015 EI 0 1.Will this property be the buyer's primary la 9 3.Homestead residence? Provide complete address of primary 9 ED 4,Solar Energy H I stem - residence.including county: 405 N.THIRD ST. 9 riq 5'Wind PRVitiSaWelgOUNTY AUDITOR Address(Number and Street) L n j t j 6.Hydroelectric Power Device Owensville,IN 47665 GIBSON o 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County 0 0 8.1s this property a residential rental property? 0 U 2.Does the buyer have a homestead in Indiana to be vacated for this residence? If yes,provide 0 0 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) 2.10 -17 -oj -4/eti - 000 3,3 ? CicZQ City,State ZIP Code County Primary property owner contact name E-mail _