Homestead_Nossett (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER / • .: s; :. . ,•- . - _ .j.& „4:11. �. 1-22 - ._ - ....-
Bryceann Cutsincier
Preparer of the Sales Disclosure Form Title
226 W. Broadway Broadway Title, Inc.
Address(Number and Street) Company
Princeton. IN 47670 812-386-1687 bti(dmw.twcbc.com
City,State.and ZIP Code Telephone Number E-mail
E.SELLER(S)JGRANTOR(S) - -
Clarice Ann Pickle
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
319 W Columbia St
Address(Number and Street) Address(Number and Street)
Under enalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
comp e�s regnfred by las ,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller f x ie Signature of Seller
Clarice Ann Pirkle 140"/7-9®/6
Printed Name of Seller Sian Date(MM/DD/nm1 Printed Name ofSeller Sian Date(M.M/DD/YYYY)
F.BUYER(S)/GRANTEE(S)=_ 1PPLICATIONPFOR PROPERTY.TAX DEDUCTIONS=IDENTIPY?ALL ITEMS THAT:APP. Y_' - .._ - __
Lori r L. Nossett
Buy erl-Namevs appears on conveyance document Buyer 2-Name as appears on conveyance document
619 Walnut St.
Address(Number and Street) Address(Number and Street) o Ne. '
Oakland City, IN 47660 ei Pk,.
-THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY'ALL OF THOSE THAT APPL,/ i�
4V3
YES NO CONDITION YES NO CONDITION 7
0 El 1.Will this property be the buyer's primary 0 ❑ 3.Homestead 04>
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling Systec
residence,including county: ❑ 0
319 W Columbia St 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Oakland City. IN 47660 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.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)
/t/8. So 02- 000.859- O07
City,State ZIP Code County
Primary property owner contact name E-mail