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HomeMy WebLinkAboutHomestead_Berry INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 [D.P.REP,ARER. ; 7T ---- y= : . T _` f*_P ; r - Leon C.Stone President Preparer of the Sales Disclosure Form Tide 226 West Broadway Street Broadway Title, Inc. Address(Number and Street) Company Princeton, IN 47670 (812)386-1687 City,State,and ZIP Code Telephone Number E-mail _E:SEL•L''SR(S)'/.GRANTOR(S).Si _L s�w., , =_ '7 : 3 ,.�. •—�- -—_' t Melinda R.Pohl Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 102 West Mulberry Street 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 r uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Alg.,d14-ti1er , z/it/i7 Sign lure of Seller Signature of Seller Melinda R Pohl Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller ipn Date(MM/DD/YYTI1 BUYER(S)%GRANTEE(S),F9P,P,LIGATION WatleROPERTY_TAX7,DEDUCTIONS IDENTIEVAPKITEMSITHATT t%, T-i;11 Brandon S. Berry Buyer)-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document • 102 WeNu Mulberry Street ' ia Address 4l Fort Bra(Number ch,IN d St 47648 Address(Number and Street) j esO , a& THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. '9(yO/T YES NO CONDITION YES NO CONDITION t7R IZI ❑ 1.Will this property be the buyer's primary 171 ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System - residence,including county: ❑ 5.Wind Power Device 102 West Mulberry Street Address(Number and Street) ❑ Q 6.Hydroelectric Power Device Princeton,IN 47670 Gibson ❑ ❑ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ Q 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 ❑ 17 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) 4 -/U d/ /dc4-�O 26 - Q�6 City,State ZIP Code County /�i Primary property owner contact name E-mail 1