Homestead_Martin (9)iuA
Brvceann Cutsinqer
Prrparerafthe Sa/a D'uAOSUre Form ii[!e
226 W. Broadwav St. Broadw�
Addres (Number and Strre[J Comyany
Princeton.IN 47670
Ciry.Smte. andZlP Code
JacnbJ Sands
Selfer 1� Nvme as appears on ronveyance dwvmenl
Addrvs (Nvm6er and Strce[)
PrincPton IN 47670
Ciry. Slatq and ZIP Cade . 1 1
Seller 2� Nome as appears an romeyantt docvmmt
Ciry, Smte. and ZIPCade
E-mail
Under penalties of perjury, 1 hereby certify that [his Sales Disclosure, to the best of my knowledge and belief, i's true, correc[
an�comple[e �s requi�red by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
F.
appears on [omeyan[e dacument
Signomrea(Seller
Buyer 2- Name as appears on conveyance
222 W. Pine St. 222 w. Pine St.
Addras (Nvmber ond Shee[J Address (NUm6e� and Svee[J
Princeton �N 47670 Princeton. IN 47670
Ciry.Smre. and Z/P Code Ciry, Smte. and ZIPCOde
THE SALES DISO.OSURE FOR.N MA1' BE USED TO APPLY FOR CERTAI.�' DEDURIOYS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLV.
� ❑ 1. Will [his proper[y be the buyer's primary (
residence? Provide complete address of primary �
residence, induding county:
9009 E Lake Road
Address (Number ond Sveet)
Princeton IN 47670 Gibson
Ciry, SwteTJPCade Covnry
❑ Q 2. Does [he buyer have a homestead in Indiana [o be
vaca[ed for [his residence? Ifyes, provide
complete address of residence being vaca[ed,
including county:
Address (Num ber ond Svee[)
Counry
G ■
■ l7
� �
� �
� �
■ G
■ ■
3 Homestead
4. Solar Energy Hea[ing/Cooling
5. Wind Power Device
6. Hydroelectric Power Device
7. Geo[hermal Energy Heatlng/C
8. Is this proper[y a residential n
9. Would you like to receive tar s
property via e-mail? (Provide c
below. Please ions c
ot availa6le in aIl counties.)
-OO�.�c
Under penal[ies of perjury, 1 hereby certify [hat [his Sales Disclosure, m[he bes[ of my knowledge and belie�
and complete as required by law, and is prepared in accordance wi[h IC 6d.1-5.5, "Real Proper[y Sales Discl
Spouse information, Social Security and Driver's License/O[her numbers are not necessary if no Homestead
b n'ng filed.) 1/ I
l PS�,nn �i �CI�iDn C.Q�.J.D �i 7.�1GU�Nw
S�gnaNreo uyer] Signa[ureofBuyer2/Spause
�p�y p Marf'n ID) ��I �� __ Krxiir D Mart'n ��
Pn"nredLegal,VameofBvyal SignDare(MM/OD/YYY1j
herNum6er
DITOR
g Device
proper[y?
ienCS for [his
�[ infarma[ion
re infarmation.
�
H mail �
� l
ie, correc[
Act". (Note:
:[ion is
�MM/UD/YYY1]
I' �