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Homestead_Hurt INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.",FREPARER : -z" Y t_ — 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 SSELIMS)%GRANTOR(S)i_ - ` T - _ - "1 L t R Thomas Stiles Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 5945 East 490 North Address(Number and Sweet) Address(Number and Street) Francisco IN 47649 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 regl • •d 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 R Thomas Stiles 7-D-7-17 Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller ggg'''���g Sian Date(MM/DD/YYYY) IF!B.UYER(S)/,GRANTEE(5) _APPLICATIO EOR,PROPERTYzTAX DEDUCTIONSz IDENTIFY; ( .� Richard Wayne Hurt 33Fiii Buyer I-Name as appears on conveyance document Buyer 2-Name as appears an conveyJruct oU n tq 017 5945 East 390 North Address(Number and Street) Address(Number and Street) f� Francisco, IN 47649 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System res e,it{cludingcounty: �� ❑ n 5.Wind Power Device ts/ umb Tae eet) -74 a ❑ 0 6. Hydroelectric Power Device J rv � � / �� ❑ 0 7.Geothermal Energy Heating/Cooling Device "frie:1_±712-70 tat e ZIP ode ) County ❑ State 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 ❑ 71 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) n/ City,State ZIP Code County (96-06-19- IDE- ©CCD Primary property owner contact name E-mail