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Repa�er of the Sala Dixlmvre Form Title
226 W Broadwav Broadw.
Addras(Nvmberand5treeQ Company
Princeton. IN 47670 812386-1687
Ciry, 5[ate, and LPCode Telephane Number
Christopher Scotl VanVliet
Seller i- Name as apprars on conveyonce docvmenl
Addres (,4umber and Streer)
Princeton IN 47670
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appears on canvryance do[umm[
Addreu (Number md5[ree[J
Under enalties of perjury, 1 hereby certify that this Sales Disclosure, to [he best of my knowledge and belief,
and m e[e s requ� d y law, and is prepared in ccordance with IC b-1.1-5.5, "Real Proper[y Sales Discic
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Signa eo/ eller � SignaNreafSelle�
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TNE SALFS DISdOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDURIONS FOR TNIS PROPERTV. IDENTIFY ALL OF THOSE TNAT APPLY.
� ❑ 1. Will this property be [he buyer's primary
residence? Provide complete address of primary
residence, including county:
AdCras (Number and 5[ree[J
Princeton IN 47670 Gibson
Ciry, Srnce7JPCade Covnry
❑ Q Z. Does [he buyer have a homesiead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
AdCres (Nvmber and Stra[)
Ciry.Sm�eZIPCode
❑ 3.
❑ 0 5. Wind Power Device
❑ 0 6. Hydroelec[ric Power Device
❑ � 7. Geo[hermal Energy Heating/Cool
❑ � 8. Is [his property a residential rent
❑ ❑ 9. Would you like ro receive tax s[at
property via e-mail? (Provide coni
below. Please see instructions for n
ot available in all counties.)
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