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Homestead_Ambrose INDIANA SALES DISCLOSURE FORD? SDF ID: Page 2 ` P,,RnA—RE21 pct .-.. `!'c:67--YiJ 'c'.`— a:r:):";=-7-7--7-(7-.-:-1--7- - --- 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 _ Ciry,State,and ZIP Code Telephone Number Email :EELS SELL'ER[S)/GRANTOR(S) tea:. , Z21„17±2,72;;;;;,,L Im - - .. ,_. - - - -I Douglas W Peach Seller 1-Nome as appears on conveyance document Seller 2-Name as appears on conveyance document 8236 West 900 South- Address(Number and Street) Address(Number and Street) Cynthiana, IN 47612 Under pen •: of per'. ,I hereby ce • hat t is Sales Disclosure,to the best of my knowledge and belief,is true,correct and?plete req by 1 w, nd • epar din accordance with IC 6-1.1.5.5,"Real Property Sales Disclosure Act". dr,._ Signaler.•(Seller / I Signature of Seller ■. . - , if I Printed Name of Seller Si,n Date A.✓00/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) ;;E`BUYER(SPGRAN,TERSIZARPLICATION(FOR P,ROPERTY:,TAXWED.UCTIONSFIDENTIEaYLL9T,EMSyTHATiAPP,bri, THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSECtj9ilY000NTY AUDITOR 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 ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Ciry,State ZlP lode caanty ❑ 0 7.Geothermal Energy Heating/Cooling Device ❑ 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) City,State ZIP Code County " co-iq-acp - too-CO 4- 115-DR 1 Primary property owner contact name E-mall