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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Bryceann Cutsincier
Preparer of the Sales Disclosure Form Title
226 W. Broadway St. Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 bti(amw.twcbc.com
City.State,and ZIP Code Telephone Number E-mail
-E.SELLERISI/GRANTOR(S) .-,..•-:. ' . :. T'.-1--:- . =.I..,:-.‘:".'11:,I. -.1_ 7.;1..C;pi3C,.721:-.:t.C....±..Cii-l'El:;.-j:::."-_•.viT':-:
Martha L Horrell
Seller I.Name as appears on conveyance document Seller 2-Name as appears on conveyance document
402 W Pike Ave
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".
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C,4-t 2-0YA ,i-wi
Signory of Seller Signature of Seller
Martha L Harrell i
Printed Name of Seller Sion Date(.01/D0fYYM Printed Name of Seller Sian Date(MM/DO/Y1111
F.BUYEk(S)/GRANTEE(S) APPLICATIONTOR.PROPERTY,TAXWEDUCTIONS7.;IDENTIMALI:ITEMs.THAT:AppLval__:_,,T,. 1 i>1'
Tim W. Dyer Kathy A. Dyer
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
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Address(Number and Street)
(0 ...i Address(Number and Street
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE Iv:A . . qp,
YES NO CONDITION YES NO CONDITION
CO0A,
0 D 1.Will this property be the buyer's primary 2 0 3.Homestead
residence? Provide complete address of primary 0 2 4.Solar Energy Heating/Cooling Slifetua
residence,including county:
0 2 S.Wind Power Device -
210 W Morton St
Address(Number and Street) 0 2 6.Hydroelectric Power Device
Oakland City, IN 47660 0 171 7.Geothermal Energy Heating/Cooling Device
City,Stare ZIP Code County
D [z] 8.1s this property a residential rental property?
. . 0 z .2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide D 2 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)
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City,State ZIP Code County
Primary property owner contact name E-mail