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Homestead_Bailey
INDIANA SALES DISCLOSURE FORM SUP ID SDO ID 1811813 Page? I D.PREPARER Bryceann Cutsinger Preparer of the Sales Disclosure Form Title 226 W. Broadway Broadway Title,Inc. Addrev(Number and Street) Company Princeton, IN 47670- 812-386-1687 samantha.bti @mw.twcbc.com City,State,and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S) Robin D.Lytle Seller 1-Nome as appears on conveyance document Seller 2-Name en appears on conveyance document 103 S.Center St. - - Address(Number and Street) Address(Number and Street) Francisco, IN 47649- Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and y4mple[ s re ired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". ti :areal Seller /J(�f .///�� Signature of Seller ob ib l9 Dt 1--y +-1e el- r PH/no-1 P "(wile. Gan or• M inn n-,-vn Pr;"-ed. onrrope. l;+"once cyan yvvm F.BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY Daniel J. Bailey Kelly L. Bailey Dwyer 1-Name as appears on conveyance document Buyer?-Name as appears an conveyance document 1604 S.350 E. 1604 S. 350 E. Address(Number and Street) Address(Number and Street) Princeton, IN 47670- Princeton, IN 47670- THE SALES DISCLOSURE FORM MAY HE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OFT E7 AT pPLY YES NO CONDITION YES NO CONDITION © n 1.Will this property be the buyer's primary © ❑ 3. Homestead AUG 10 2015 residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 103 S.CENTER ST. ❑ © 5.Wind Power D- e - n �; Address(Number and Street) n © 6.Hydr'oe.1QC2LL e ii''a'.4 .b Francisco,IN 47649 G r•-= ba�lktlal E 6 UNTY AUIDIT°F� Cit.State ZIP Cade County n El 7.Geothermal Energy Heating/ oolong evice rn n 2. Does the buyer have a homes •=e in Indiana to be n © 8.Is this property a residential rental property? vacated for this resider . If yes,provide ❑ El 9.Would you like to receive tax statements for this complete adore - . residence being vacated, property via e-mail?(Provide contact information ludina -.linty: below, Please see instructions for more information. 1604 S. 350 E. Not available in all counties) Address(Na .and Street) a6- I 3- ^A _/01 _ '1 r�y q c Princei.', N 47670 GIBBON VVV (��/�f/\ '(/ ►C/1�/\ Ci .State ZIP Code County Primary property owner contact name E-,nail