Homestead_Davis (22) D•INDIANA SALES DISCLOSURE FORM - _ SDP ID: - - ,_ Page.2-
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c_Ray M.-Druley - ..-f Attorney No.4759-26
Priparer of the Sales Disclosure Form Title
505 N.Church Street,PO Box 146 Law Office of Ray M. Druley
Address(Nuinber aid Street) Company
Fort Branch,IN 47648 812-753-4975 druleylaw(awahoo.com
City,State,and ZIP Code Telephone Number E-mail
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MELIA ft1 /,GRAN7TOR(S)r :?:.:.}_J :o. ».,"-.. o. 4;.. E;s<.. ;�t-•s s . `J: _ r -� . ,`s ' -<(“ ;'•' •�
Bruce A--Davis Sunressor Trustee
Seller 11 Name ai appears on conveyance document Seller 2-Name as appears on conveyance document
109 S Broadview Circle Dr
Address(Number andStreet) Address(Number and Street)
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Under penalties of perju- 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
al. mp
olete as re if e y IaW,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller - Signature of Seller
Rntre-H 'Davis SurressnrTnistee Dec 12 2017 - - _ -- -
"PnnttdNain,eofSeller. .__... .. _. . . .Sign B to(MM/DD/YYYY) Printed Name of Seller - .. Sign Date(MM/DD/YYYY)
F B,WER(SAGRANTEE(S) AP,P,CIGATIONIECOR,ROP,ERVM%AX{UED.UGTIO•NS IDEN7TIFYIA'LLyhTE aAP,PIbY i;a :Z, 4"' F`.'n �'i
•- Bruce H 7 Davis
euy'er7 Name as appears on convryance document Buyer 2-Name as appears on conveyance docum
109 S.-Broadview Circle Dr. DE �/
. Address(Numberand Street) Address(Number and Street) (- T
Princeton, IN 47670 _ < 3 20/7
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLYA 00f?,OR
YES . NO CONDITION - YES NO CONDITION
1.Will this property be the buyer's primary 0 ❑ 3.Homestead
. residence? Provide complete address of primary ❑ ri 4.Solar Energy Heating/Cooling System i
residence,including county: ❑' 0 S.Wind Power Device - -
109.S:Broadview Circle-Dr.
Addied(Namber and Street) ❑ Q 6.Hydroelectric Power Device
P'rinceto'n, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County 1
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 B.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)
Z 6,//- /a '3G/ CMS95 CD?
t Ciry,State ZIP Code County -
Primary property owner contact name _ . E-mail.. - -
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