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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
.D;:PREPARER ,. .- -_ .. . , - . - - - :- - _
Britany Barnes Agent
Preporer of the Sales Disclosure Form Title
226 W Broadway Broadway Title, Inc
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 britany.bti @mw.twcbc.com
City,State,and ZIP Code Telephone Number E-mail
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E.SELLER(S)/GRANTOR(S) -
James P Pegram Kelly L Pegram
Seller I•Name as appears on conveyance document Seller 2-Name as appears on conveyance document
7913 S Andee IN 7913 S Andee L N
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete asje wired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real P erty Sales Disclosure Act".
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Signature o eller (/ Signature of Seller
.SAIAes ?, ∎.6 vt ) o/I(1.2a"7 / LLv L . E6RAm /0-Ho 4017
Printed Name of Seller Sian D6(e inpao/Y)l ) Printed Name ofSel'r Sion Dave(...01/oomYY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONSc-IDENTIFY ALL ITEMS THAT-APPLY • - . • . '
Kale J Christy _
Buyer I-Name as appears on conveyance document Buyer Name as appears on conveyance document ' _ - ' ` '%
6137 TILT+ I A . b _ • .
RI xcl Q 1)T p i / j
_address(Numoer and Street) Address(Number and Street)y
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY
h I tiPUN COUNTY AUDITOR
YES NO CONDITION YES NO CONDITION
N ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ IN 4.Solar Energy Heating/Cooling System
residence,including county: ❑
7913 S Andee LN : 5.Wind Power Device
Address(Number and Street) ❑ C21 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson
❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ IN 2. Does the buyer have a homestead in Indiana to be ❑ 8.1s this property a residential rental property?
vacated for this residence? If yes,provide ❑ EN 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) a&_/q— 19.. IC)3_ ca aas -cdb
City,State ZIP Code County
Primary property ownercontact name E-mail
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