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Homestead_McCarty (3) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 =p)iP,REI?ARERL Britany Barnes Agent Preparer of the Sales Disclosure Form Tide 226 W Broadway Broadway Title Inc Address(Number and Street) Company Princeton, IN 47670 812-386-1687 britany.bti(Tmw.twcbc.com City,State,and ZIP Code Telephone Number E-mail [ELSEL-LER(S)/GRANIIT R(S)L ' - I James M Martin Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 411 S Bradley Dr 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 an mplete as required by law is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". __nn / Si ture of Seller Signature of5e11¢tpp���,' esM Martin /0 _°^(3.f , n Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of JYln!r , IT IF,,:7'. ..n.•r PFR PfRTAXl UMhate(M.M/DD/YYYh E:B_WifER(MG RQN/TEE(SWFWICATIQNLF_CMRROPERTYLTAX;DERUCTIONKH—S NTIF_Y`AtiIV S. HATrA Piro irMer - "- ,j a �:1J .. Barry Blaine McCarty Robin Lynnette McCarty a.., „I — ----- Buyer I-Name as appears on conveyance document Buyer 2-Name asappea+rvntonve'yance.ou •• 411 S Bradley Dr 411 S Bradley Dr I � ! VCi 4— Auditor Address(Num ber and Street) Address(Numg oy bej �.n iis:'V.",A•'Nt II ITOR Gibson County . Haubstadt, IN 47639 H. • t-.t IN 47. • ' THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. • •• ._ • . . - :•PLY. YES NO CONDITION - NO CONDITION E ❑ 1.Will this property be the buyer's primary [ ❑ 3. Homestead residence? Provide complete address of primary /I © 4.Solar Energy Heating/Cooling System residence,including county: 411 S Bradley Dr ❑ ig 5.Wind Power Device Address(Number and Street) ❑ IZ 6. Hydroelectric Power Device Haubstadt, IN 47639 Gibson ❑ 117 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code Coun ❑ ❑ 2. Does the buyer have a hov el t1Ind a .0 ❑ 8. Is this property a residential rental property? vacated for this residence. f ye ; di e-/ . ❑ 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: OCT 2 5 2017 below. Please see instructions for more information. Not available in all counties.) Address(Number and Street) .; a_a3-CJ -iO3 -00o.s . s-ocf ay._si�7R►, City State ZIP Code GIBSON COUNTY AIf?3YTOR primary property owner contact name E-mail