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Homestead_Riedford INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 :D.PREPARER • ? ' . , - . Bryceann Cutsinoer Preparer of the Sales Disclosure Form Title - 226 W. Broadway St. Broadway Title, Inc. Address(Number and Street) Company Princeton, IN 47670 812-386-1687 bryceann-bti(Wmw.twcbc.com City,State,and ZIP Code Telephone Number E-mail E.-SELLER(S)/GRANTOR(S) _ Urban D Floers Seller I Name as appears on conveyance document Seller 2-Name as appears on conveyance document 4752 F 1200 S Address(Number and Street) Address(Number and Street) Haubstadt IN 47639 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 re uired 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 Urban n Flnnrs -b' '-/7 Printed Name of Seller Sian Date INM/DD/YYYYI Printed Name of Seller Sion Date(MM/DD/YYY11 .F.BUYERIS)%GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY.ALL ITEMS THAT AP Y• Scott A. s Buyer I-VaRiedford e as appears an conveyance document Buyer 2-Name as appears an conveyance document ` 5787 W. 800 S. „pi)Addr Address(Number and Street) Address(Number and Street) Owensville, IN 47665 4% THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLV."1.1/4r YES NO CONDITION I YES NO CONDITION YqU 1.Will this roe be the buyer's primary 0/T IA ❑ property rty y p ry � ❑ 3.Homestead OR residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence, including county: 4752E 1200 S ❑ MI 5.Wind Power Device Address(Number and Street) ❑ E 6.Hydroelectric Power Device Haubstadt. IN 47639 Gibson ❑ z 7.Geothermal Energy Heating/Cooling Device City,State 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 ❑ 171 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 -4,3 /3/d0- 60/.392 60 Pnmary property owner contact name E-mail