Homestead_Burns INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Bryceann Cutsinger
Preparer of the Sales Disclosure Form Tide
226 W. Broadway Broadway Title, Inc.
Address(Number and Street) Company
Princeton. IN 47670 812-386-1687 blemw.twcbc.com
City,State.and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
Brent A Wrioht Rebecca N Wright
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1947 S 1200 P 1947 5 1200 F
Address(Number and Street) Address(Number and Street)
Oakland City IN 47660 Oakland City IN 47660
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".
�.v p""/�f�i�r`' oO/tai) . � ie.•-+✓mot...,'(% °a/a.91201 7
Signature of Seller t Signature of Seller Q
o
Brent A Wright Rebecca N Wr9ht
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sign DateWM/DO/YYYY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THATAPPLY-, . •.
Laura Ann Burns
Buyer s-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
? A4) V 'rle 3* .
Address(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLS'O0 !,
UI. "�'
YES NO CONDITION I YES NO CONDITION -r fi•/e
.
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead .loo,
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System R
residence,including county: ❑ 0 S.Wind Power Device
1947 S 1200 F ❑ 0
Address(Number and Street) 6.Hydroelectric Power Device
Oakland City. IN 47660 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIPCode 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) �/(/� /7/�
City,State ZIP Code O -/5-i9—/a - a tt 6 77 026
County
Primary property owner contact name E-mail