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Homestead_Michel Jr i INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER - • . SHERI L. GREENE Preparer of the Sales Disclosure Form Tide 1122 E.OHIO ST Address(Number and Street) Company PRINCETON, IN 47670 812-664-1005 City,State,and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S) _ . BEN.IAMIN W MICHFL SR MARILYN S MICHFI Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document 206 S SPRING ST 206 S SPRING ST 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 g mplete as required by law, s pr ar din ccordance with IC 6-1.1-5.5,("Real Property Sal s Disclosure Act". Signori 1Seller S(gnamreo eller BENJAMIN W MICHFI SR 8 /30 /2017 MARILYN S MICHEL FILE n /7017 Printed Name ofSeller Sian Date(MM/DD/YYYY) Printed Name o Seller J tto-o-rl�l�eeee����MM/aa Yril ,F,'BUYER,S,/raAALIEZ(S)\APPLICATIONFOR PROPERTY TAX.DEDUCTIONS-IDENTIFY ALL ITEMS.THAT APPLY . EAMIN W. MICHEL JR 1 AUG 3 u LUl/ NJ duyvr1-nvmeaSOppebrs on[anveyante ocument Buyer 2-Name as appears on conveyance document 1101 E. BROADWAY ST _ • i ;Ii Address(Number and Street) Address(Number and Street) GIBBON COUNTY rAUDITOR PRINCETON. IN 47670 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 V FDrf19#l� Q ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead residence? Provide complete address of primary ` ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ 1101E BROADWAY ST 5.Wind Power Device Address(Number and Street) ❑ IZ 6. Hydroelectric Power Device PRINCETON, IN 47670 GIBSON ❑ Q 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 ❑ 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) 016 - /a - of - 3o , - o0,3. /85 _ 0 AS) City,State ZIP Code County Primary property owner contact name E-mail