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Homestead_Willis (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 -DYP,REPARERt _ '. f-7,7t.-1-27:177,7---71_1, ,,,‘ ;::: -: —n ,r :- :..;C: _ 7-- Bryceann Cutsinoer Preparer of the Sales Disclosure Form Title 226 W.Braodway Broadway Title. Inc. Address(Number and Street) Company Princeton, IN 47670 812-386-1687 samantha.bti(Emw.twcbc.com City,State,and ZIP Code Telephone Number E-mail E=SHLLER(S)"/-GRANTOR(S)7.2 t.r i r .C . , ` .7 4, ° QT:• ; . ' . r: _ `L_ '_,7:_ "+ '-- Timothy Wayne Dyer Kathy Ann Dyer Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 12135 F Hickory Ln 11135E Hickory I n Address(Number and Street) Address(Number and Street) 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". \LSN'N% k v gna[ure of Seller ! /� Signature of Seller Timothy Wayne Dyer V "' Kathy Ann Dyer c-2 o "j (o Printed Name of Seller Sipn Date(•M/UD/YYYY) Printed Name of Seller Sign Date(MM/DDATYI) ,FSBUYER(S)/GRANTEE(S)iiAP:PLICAT10NFOR.PROPERTY_TAX?DEDUCTIONS=IDENTIF-YtdGCiITEMSTHAT.APPLY;:?? _.;,-n _ Jonathon A.Willis Ashley E.Willis Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 10426E 350 S 10426E 350 S Pit.... THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF mot 496, Y. u eph, YES NO CONDITION •r6 • IV izi ❑ 1.Will this property be the buyer's primary Z ❑ 3.Homestead CO �, residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Coo ing '-_te residence,including county: ❑ Fl 5.Wind Power Device 414 12135E Hickory I n TO Address(Number and Street) ❑ ( 6.Hydroelectric Power Device R Oakland City, IN 47660 ❑ M 7.Geothermal Energy Heating/Cooling Device Ciry,State ZIP Code County Z ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Z 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. 10426 E 350 S Not available in all counties.) Address(Number and Sheet) ��--vy--,��� CO Oakland City, IN 47660 Gibson �t 74//9 �W.J-COO 3 e0- CO City,State ZIPCode County Primary property owner contact name E-mail