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Homestead_Braun INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D:PREPARER._ Britanv N. Barnes Searcher Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title, Inc. Address(Number and Street) Company Princeton, IN 47670 812-386-1687 Britany.btiemw.twcbc.com City,State,and ZIP Code Telephone Number E-mail . : _E.SELLER(S)/GRANTOR(S) - > ' , .- -.: Timothy W I ewis Elivabelh A 1 ewis Seller I-A'ame as appears on conveyance document Seller 2-Name as appears on conveyance document 1110F600S 1110E600S Address(Number and Street) Address(Number and Street) Fort Branch IN 4761,1I{ Fort Branch IN 4769:51 Under penalties of perjury, 1 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 D'sclosure Act". '^1 ,— (/k r lit_/ " \ a �i�f�_v- Signature of ter Signature of Sell Timothy W I ewis Z—/Z— /S fliiaheth A I ewis Z/ _ / ?, /—C Printed Name of Seller Sian Date(MM/an/Y117) Printed Name of Seller Sign Date(M.M/DD/1m'1 F.BUYERS)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX-DEDUCTIONS-IDENTIFY:ALL ITEMS THAT APPLY - - _. Tyler K. Braun Deidra L. Braun Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 4961 N Co Rd 200 E 4961 N_Co Rd 200E Address(Number and Street) Address(Number and Street) Petersburg, IN 47567 Petersburg IN 47567 FILED THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT.SPPLI'. J CU1J YES NO CONDITION YES NO CONDITION vs, iC 0 ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead )I f7J{ residence? Provide complete address of primary ❑ © 4.Solar Energy ��/SQWkTS�sthl�,t�ITOR residence,including county: ❑ IA 1110E 600 S 5.Wind Power Device Address(Number and Street) ❑ 171 6. Hydroelectric Power Device Fort Branch, IN 47666 ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County IN K ❑ 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 ❑ Z 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information r,, including county: below. Please see instructions for more information. G j t Co e-a t "b r Not available in all counties.) Actress(Number an trees 7T-- 6(,eGZ���S�i 1 >-c 210-/9 - o - Q00 0007 // oa5 City,State ZIP Cade County Primary property owner contact name E-mail