Homestead_Grubb (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
I D.PREPARER - . - - •
Jerry D.Stilwell Attorney at Law
•
Preparer of the Sales Disclosure Form Title
302 N.Prince Street Bomberger,Foreman,Oswald&Hahn,LLP '
Address(Number and Street) Company
Princeton,IN 47670 812-386-6482
City,State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTOR(S) • . - - .. -
Jane Ann Fisher
Seller l-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
919 Mill 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 complete as required b law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
2C 4.
• Signa re of Seller Signature of Seller
Jane Fisher 01/132017
Print Name o Seller Si•n Date MM/DOAIy/ Printed Name a Seller i ,*;fl11Par;•ote(MM/DD/ YI
F.B t _- GRANTEE S -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL : ;IA 1••),_'. 7. "
t Connie Grubb -1
�er l-Name as appears on conveyance document Buyer 2-Name as appears on canveyancefgpmeR r1--2Q1l
815 South Race Street HH�I`V7 11 /
Address(Number and Street) Address(Number and Street) fli,,'' -
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 I YES NO ONOI ION
0 ❑ 1.Will this property be the buyer's primary / 0 ❑ 3.Homestead
residence? Provide complete address of primary U LC 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0
S.Wind Power Device
Address(Number and Street) ❑ N 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El 2.Does the buyer have a homestead in Indiana to be n N 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ N 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provij contact information
including county: below. P •• • •• '•• . more information.
Not available in all counties.)
Address(Number and Street) SS J �qr ` p R
City,State ZIP Code lh --/", - / - O`a,'76oI. .3 -Oe'
Co o
Pcimary perry owner contact name / E-ma'