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Homestead_Halsne
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 DABREPARERt3:1- - _ t.,:�� r Fr - s r r• ^_ ° tic, a�}L_..K,. .-ter Zr'� CLC-c :.ai�1.SLi-JCL r✓LL+�li.i_.a".��.C_�Psi - f,Y r. y �.i�: •�l- Bryceann Cutsinger Preparer of the Sales Disclosure Form Title 226 W. Broadway Broadway Title. Inc. Address(Number and Street) Company Princeton, IN 47670 812-386-1687 samantha.btiemw.twcbc.com City,State,and ZIP Cade Telephone Number E-mail E:SELLER(SWGRANTOR(S)-. _ 32Tri".w i:_1'I L t.2 a i c ice` r'_ #`"`<'• sf _; �>' L D&G Fstates I I C by t;regnry A Burger Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document 6250 S 175 E Address(Number and Street) Address(Number and Street) Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my kno d.j �`•d b:l :-,i; ) ,correct and omplete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Pr -: ,t .: F'. -I 4, /Act". (/V�� °%� P'_e-` `�� 'L FEB 2 9 2016 Signs (Seller / Signature of Seller D R(;Fstates I LC by Gregory A Burger 0,2---7Ce Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller /If • R ion Date CMM/DO/YYYYI -F:Buy ER(S)%GRANTEE(S) APPLICATIONFORR.PROPERTYTAXIDE RUCTIONS-_IDENTIFYALL,ITEMSrTHAN-APPKNaT ___ lal:ii)a,9 Llit,iF t I C JL,'f t t c William A. Halsne Christine J. Halsne Buyer 1.Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 608 E.Water St.Apt.A 608 E.Water St.Apt.A Address(Number and Street) Address(Number and Street) Princeton, IN 47670 Princeton, IN 47670 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION ❑ 1.Will this property be the buyer's primary ® ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ ❑ 501 N Brownlee Ave 5.Wind Power Device Address(.Number and Street) ❑ ( 6. Hydroelectric Power Device Princeton,IN 47670 Gibson ❑ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County El C3 2.Does the buyer have a homestead in Indiana to be ❑ $ Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 0 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) City, ZIP County - gel - 003. 59.3-0a ry Primary property owner contact name Email