Homestead_Douglas (7) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.-PREPAREIC :-.:.`,".. -'my :?. T." .; - e :.. -,--i :Ticz:::--. ,,f-..77,1:27_1;-;:71;:c*:3":"•WS;5 7 7 7---.:-.7.;;,-C 7,3.1C 7 7 7.71:7-:::7 1.7.
Bryceann Cutsinoer
Preparer of the Sates Disclosure Form Title
226 W.Broadway St. Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 476700 812-386-1687 btiemw.twcbc.com
City.Stare,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOKS).2. 1....;-..e... , - • : 1.7:::_-',_..1'::.15,l : g:',:di.t:t..dr :, 17.,---;),;;<tt, "111;.7,
Larry J Parrley
Seller I'Name as appears on conveyance document Seller 2-Name as appears on conveyance document
515 N Hart St
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
Under penalties of perj Al I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and corn teas requi Zr•y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller 1 SignatureofSdler
1-5-4_0 i e;
1 arry.1 Palley /6
Printed Name a/Seller Sian Date(AIM/OD/MO Printed Name of Seller Sian DateNM/0VMM
F.BUYER(S)/GRANTEE(S) APPLICATION FOR7PROP.ERTITAX7DEDUCTIONSJDENTIF.WALLITEMS!THAT APPLY.!1,-.--;:.7";TI,
• -
Stephen Alan Douglas , Sharon M.Douglas
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1368 S. 100 W. 1368S. 100W.
Address(Number and Street) Address(Number and Street) 111)
Princeton,IN 47670 Princeton, IN 47670
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P:S• ' • I 'TI A •LL OF THOSE THA- PPLY.
YES NO CONDITION 41011111 NO CONDMON
— : -ir I
.".401.17":
0 17) 1.Will this property be the buyer's primary M [1: 3.Homestead r
residence? Provide complete address of primary = in . , ,- : . : -- :rooting System
residence,including county:
D 19 5.Wind Power Device
1368 S 100 W
Address(Number and Street) El 0 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson 0 E 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Cade County
li 0 8.Is this property a residential rental property?
111 0 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide lif 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) ac o.--1,) -b(0-41-o I -oca . i do-o a1/43
City,State ZIP Code County
Primary property owner contact name E-mail _