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INDIANA SALES DISCLOSURE FORM SDF ID:
D[PREPARER-'� � ' � � - � -
Britany N Bames Searcher
Preparer oJthe Sales Disclorure Form ii[le
226 E Broadway Broadway Title, Inc.
Addrcss (NUmber md 5[reee) Compony
Princeton,IN 47670 812-386-1687
Ciry, S[u[e, ond ZIPCade Telephone A'um6er
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Rosa Marshail
Seller 1� Nome as apPears on ronveyvnce dorumen[
122 East St.
Addren (Number and5[rxl)
Princeton,IN 47670
Ciry, Smtt. ond ZIPCode
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ar appears on [onvqvn[e darumen[
Address (Numbe� and Svre[J
Under penalties of perjury, 1 hereby certify that [his Sales Disclosure, to [he best of my knowledge and belief,
and ta�lplete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Proper[y Sales Disdc
e
E.
511 S Dongola Rd.
Address (Number and Street)
Oakland City, IN 47660
Signalure
IDENTI FY ALL7TEMS.THAT
appears on ronvqvnm docummt
Address (NUmber ond S�reetJ
Ciry. Sm¢.
THE SALFS UISCLOSURE FONM MAY BE USED TO APPLY FOR CERTAIY DEDURIOYS F00. THIS PROPERTY. IOEM'IFV ALL OF THOSE
YES AO CO.�'DITION }
❑✓ ❑ 1. Will this property be the buyer's primary Q✓ ❑ 3. Homestead
residence? Provide comple[e address of primary
residence, including county:
727 N. East St.
Address (h'umber and Svee[)
Oakland City, IN 47660
Ciry, Smh ZIPCode Counry
❑ ❑ 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:
� ❑✓ 5. Wind Power Devic�Q�/e
❑ ❑✓ 6. Hydroelec[ric Power Devfre
� 0 7.Geother�Ene ea[m ,
❑ ❑✓ 8. Is this prope ,r�� A�
❑ ❑✓ 9. Would you like to receto�l2�.
proper[y via e-mail? (Providi
Not available in all counties.)
.......... ........_.. ....,. _.....,
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Under penalties of perjury, 1 hereby certify [hat this Sales Disclosure, [o [he bes[ o(my knowledge and belie'.
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Proper[y Sales Discl
Spouse in(ormation, Social Security and Driver's License/Other numbers are no[ necessary if no Homes[ead
Vinceni E. Brock ��7 —�S ' /,$ ^
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