Homestead_Barney P
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
I 1I)u&REP,ARERI ,,:' s . -
Leon C.Stone President
Preparer of the Soles Disclosure Form Title
226 West Broadway Street Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 (812)386-1687 bti(ahmw.twcbc.com
ay,State,and ZIP Code Telephone Number E-mail
IE14`SEBLLER-- S/,GRANtTOR(S) r r ._ . :- r-z —mil
Melanie S Cates
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
6139 N SR 65
Address(Number and Street) Address(Number and Street)
Patoka.IN 47666
,
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and mplete as require y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller `yJY Signature of Seller
Melanie S Cates 1241 in
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
IF? BUXER(S)1/GRQ�TEE(S) WPtP,LICATIONWLO RGP ROEERTLYa!AXIDED_U,KIONSI?IDENITilEYML ITEMSiTi AIVPLP.LY/ "''"-ct4
William J. Barney Balinda S. Barney
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance docum nt
6139NSR65 - 6139NSR65
Address(Number and Street) Address(Number and Street) j�
Patoka,
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF T y1t PPIY.
YES
l CONDITION YES NO CONDITION °OA/t,
0:Aft>,17 4PV
El 0 1.Wilthis property be the buyer's primary [7] ❑ 3. Homestead a
residence? Provide complete address of primary -4/in❑ 4.Solar Energy Heating/Coolin `S
residence,including county:
6139 N SR 65 ❑ ig 5.Wind Power Device
Address(Number and Street) ❑ 2 6. Hydroelectric Power Device
Patoka, IN 47666 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 ❑ 0 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 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)
zlo-o5 -57-/a I0o3. 036 0/7
City,State ZIP Code County
Primary