Homestead_Harpe INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
ID.PREPARER` ' - - -
Leon C. Stone President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 (812)386-1687 bti(Wmw.twcbc.com
City,State,and ZIP Code Telephone Number E-mail
IE.SELLER(S)/GRANTOR(S) - - - - - - '
Daniel S Yancy Charlotte M Yancy
Seller 1-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
615 S Barn Lane 615 S Barn Lane
Address(Number and Sweet) Address(Number and Street)
Princeton IN 47670 Princeton. IN 47670
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a�omplete . rpquired by law,and is prepared in accordance th IC 6-1.1- 'Real Property Sales Disclosure Act".
S ofSelll l
gna[urea Seller / Sl na reo Seller
Daniel S. Yancy /6//9/�' Charlotte M Yancy Ie L�
Printed Name of Seller Sign Date MM/D /YYYYI Printed Name of Seller Sian Date MM/D /Y
IF. BUYER(S)/GRANTEE(S) APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL AT j
�ica Hare �J
D��,.. 1 me as appears on conveyance document Buyer 2-Name as appears on cony ce Altair(
615S Barn Lane OCT �, � 2617 Address(Number and Street) Address(Number and Street)
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 YES ,1 1 DITION
0 111 1.Will this property be the buyer's primary 0 ❑ 3. Homestea.
residence? Provide complete address of primary • (A 4. Solar Energy Heating/Cooling System
residence,including county: ❑ IN
615 S Barn I one 5.Wind Power Device
Address(Number and Street) ❑ R 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 0 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)
46 - 11 -15 - loo - oo3. 8a3 - o A7
City State ZIP Code County -Primary property owner contact name E-mail