Homestead_Heimbuecher INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Britany N Barnes Agent
Preparer 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
E.SELLER(S)/GRANTOR(S)_ '
Charles M.Frederick Jana K. Frederick
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2109 N Carithers Rd 2109 N Carithers Rd
Address(Number and Street) 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
and mplete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Propl't'Sales Disclosure Act".
°'.,.to% �A✓xofS /1.-1-n dI ti. �.l Z>
Signature of Seller gnature of
Charles M. Frederick a -2/-/t Jana K. Frederick a- a /_ j t'
Printed Name of Seller Sian Date(MM/DOMYm Printed Name of Seller te(MM/DO/1TYn
E.BUYERS)%GRANTEE(S) APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL 1 1 T'A Y
Shawn K. Heimbuecher
Buyer I-Name as appears an conveyance document Buyer 2 Name as appears on conveyance document 2 U
4328 S 850E FEB 2 3
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660
' '
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ L' 4.Solar Energy Heating/Cooling System
residence,including county:
4328 S 850 E ❑ [�j-�� 5.Wind Power Device
Address(Number and Street) ❑ yf 6.Hydroelectric Power Device
Oakland City, IN 476660 Gibson ❑ uri 7.Geothermal Energy Heating/Cooling Device
City,State Zl Code County ❑
❑ 2.Does the buyer have a homestead in Indiana to be 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)
Cory,State ZIP Code County
Primary property owner contact name E-mail