Homestead_Fletcher (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
1).PREPARER t
Patti Kolb Closing Manager
Preparer of the Sales Disclosure Farm Tide
226 W Broadway St Broadway Title, Inc.
Address(Number and Street) Company •
Princeton, IN 47670 812-386-1687 gatti.btk@mw.twcbc.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) . : -
Perry K Dishon
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
531 cd-i coo S'
riress(Nymber and Street) Address(Number and Street)
g, , I t- C--;v 1-1 —I LA y—1 ( ? 0
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and,��Jn�plete as requiredZby law,/a�n�d is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Perry K Dishon 3" a 2— / 7
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date tNM/DD/YYYY)
F.BUYER(S)/GRANTEE(S)---APPLICATION FOR PROPERTY TAX DEDUCTIONS--IDENTIFY.ALL- Y 1T
(etsy L. Fletcher)
B erI71-Nee��appears on conveyance document Buyer2-Name as appears on conveyance acumen
VJIJ LET 4 1" Ao ,
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 APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary /[�0 3. Homestead
residence? Provide complete address of primary \ 0 LA 4.Solar Energy Heating/Cooling System
' I I csidefrIeN�udipg c�unty: ❑
E.-1N Y J 5.Wind Power Device
Addr nj.lm ra9dStreet)C � �� / .7D �• ( �\ ❑ 6. Hydroelectric Power Device
f0 I� �l ❑ El 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code I County
IA
❑ 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)
a6— !d - 07 - ?O/ - OO/. ao9- 0J- 8
City,State ZIP Code County
Primary property owner contact name E-mail