Homestead_Humphrey INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARE R "r 274 .i ' --� =._�• _JvtTJ'.A• .L Nom.�:d._.-`r'..�1:
Bryceann Cutsinger
Preparer of the Soles Disclosure Form Title
226 W. Broadway Broadway Title,Inc.
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 bti(a)mw-twcbc.com
City.State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTOR(S)
Clinton A Rumble
Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
9520 F 450 S
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".
Signature of Seller Signature of Seller
Clinton A Rumble 1)23)r-1
_printed Name of Seller Sian Date MMMM/DD/Yfl'Y) Printed Name or Selle Sian Date(MM/DD/YM)
F.BIJYER(S)/GRANTEE(S-)-.APPLICATION FORPROPERTY;TAX"DED�UCTIONSciDENTIEYALL'ITEMS THAT .- _� _____
(Matthew D. Hums. . / P.my r Humphrey------. ��
(ll Hu er1N.,, conveyance document -\,'Buyer. Numeasappears conveyance document
_ 7146 E.SR 64 qq
Address(Number and Street) Address(Number and Street) Jryyt/ `gar
Francisco, IN 47649 Francisco IN 47649 2620/
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. Tr
YES NO CONDITION NO COBDITI C/Tof
IZ ❑ 1.Will this property be the buyer's primary 171 ❑ 3.Homestead
residence? Provide complete address of prima ialm•.r, oar nergy heating/Cooling System
residence, including county: ❑ 0 S.Wind Power Device
9520 E 450 S
Address(Number and Street) ❑ 6.Hydroelectric Power Device
Oakland City, IN 47660 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
Citv,Stare ZIP Code County
❑ 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 ❑ 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)
a,- /3- 3.5- ,5oo- 000.ea2 066
City,State ZIP Cade County
Primary property owner contact name E-mail