Homestead_Schnell INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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D. PREPARER
Jennifer L Mayer Searcher
Preparer of the Sales Disclosure Form Tide
226 W Broadway Broadway Title Inc
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687.
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(5)/GRANTORS]
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Randall Thomas
Seller l-Name as appears on conveyance document Name as appears an conveyance document
R
Address(Number and Street) /-7 7‘72.) Address(Number and Street)
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".
Signature ofSeller /� Signature of Seller
Randall Thomas Y — 23-i5
Printed Name af Seller Sian Date WMM/DD/YYYY) Printed Name of Seller Sian Date(M.I/OD/YYYI)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
Isaiah CR Schnell Olivi- R Schn-II 1
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Buyer I-Name as appears on conveyance document Buyer 2-,lame as appears an conveyance dacumen.' , •
119 E 12th St Aot 1 119E 12th St Ast 1
Address(Number and Street) Address(Number and Street)
Mount Carmel, IL 62863 Mount Carmel, IL 62863 SFP
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. WI/
YES NO CONDITION YES NO CONDITION A if"
/T
(7 ❑ 1.Will this property be the buyer's primary WI ❑ 3.Homestead
residence? Provide complete address of primary ❑ Gd 4.Solar Energy Heating/Cooling System
residence,including county: ❑
1007 S Hall St S.Wind Power Device
Address(Number and Street) ❑ RI 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
ill 1ZI 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 ❑ g 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)
£-/A -/P-/63- O/ 43- M?
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City,State ZIP Code County
Primary property owner contact name E-mail