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Homestead_Mowery INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 aDME—PARER:SZA4 r .M =me - • -= ''` s 3 - Timothy Bottoms Sheriff Preparer of the Sales Disclosure Form Tide 112 E Emerson Street Gibson County Sheriffs Office Address(Number and Street) Company Princeton IN 47670 812-385-3496 City,State,and ZIP Code Telephone Number E-mail IE SEEI ER(S)'/GRANTOR'[S) & a -T _ . -` :` :> f - - ' — Timothy Bottoms Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 112 E Emerson Street Address(Number and Street) Address(Number and Street) Princeton IN 47670 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and com as required by law and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seiler Timothy Bottoms 06/16/2016 Printed Name of Seller Sian Date(MM/Dl/nr Printed Name of Seller Sian Date(MM/DD/WW) F1BUYER(SI%GRANTEES AP,PEIGAT1O\1 0R TP,ROPERMTAttEDUGTIONSEIDENTIEY;'ALL`ITEMSiTHATAP.P,LY ra Robert R. Mowery Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1837 W Burlington Place Address(Number and Street) Address(Number and Street) 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 IN ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System residence,including county: n S.Wind Power Device Address(Number and Street) ❑ Q 6.Hydroelectric Power Device City, ZIP County [1] Ed 7.Geothermal Energy Heating/Cooling Device SI❑ 0 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 ❑ Fl 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) C.-r,— n - 04a. City,State ZIP Code County Primary property owner contact name E-mail