Homestead_BrubakerSDF
C. Dean Higginbotham Attomev -at -Law
Preparer of the Safes Disclosure Farm I the
Princeton Indiana 47670
gry, Sat and ZIP Code
Ann Morgan
Seger ] - Name as appears an conveyaue document
Address (Numberand Street)
Higginbotham Law Office
company
E -mail
Seiler 2 - Name as appears on conveyance document
Address (Number and Street)
City, State, and ZIP lode
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 requirAed by law, and Is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act".
N
Buym I
Address (Number and Street)
•
TAX D
signature orSeller
uuYer Z - Name as appears on conveyance document
Address (Number and Street)
City, Sate,
THE SALE DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
yyY S NriOii CONDITION NO CONDITION
1. Will this property be the buyer's primary ® 3. Homeste
residence? Provide complete address of primary ❑ 4. Solar Energy Heating /Cooling System
residence, including county:
❑ ❑d 5. Wind Power Device
Address (Numberand Street)
Cry, State ZIP Coda Co. .
❑ ❑✓ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Address (Numbs and Streea
ary, SmtoZIP code County
❑ ✓❑
6. Hydroelectric Power Device
❑ Q
7. Geothermal Energy Heating /Cooling Device
❑ I❑
8. Is this property a residential rental property?
❑ ❑✓
9. Would you like to receive tax statements for this
property via e-mail? (Provide contact information
below. Please see instructions for more information.
Not available in all counties.)
o�lo-oI0 /0 - ofOD -ldDO .S� x%00/ /✓
mmaryproperryoumer con[actname - — �� `� V Vl.l ( E-ma7
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 nd Driver's License /Other numbers are not necessary if no Homestead Deduction is
being file o
Printed
Number
Signature o(Buyer2 /spouse
Printed Legal Name ofBUyar 2 /Spouse Sign Date(KV /DD/-M
Lasts d igits of BuyerZIspouse Drivers state Last 5 Digits ofS•onal Security
Number License /ID /Other Number