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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
I.D). -" = ` • ; - .•
Leon C.Stone President
1Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title, Inc.
'-Address(Number and Street) Company
Princeton, IN 47670 (812)386-1687
City,State,and ZIPCode Telephone Number E-mail
iE..SELLER(S)`/.GRANTiOR(S) — -
Kim S.Glavich Mary L Glavich
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1192 Pelton Road 1192 Pelton Road
Address(Number and Street) Address(Numbe?and Street)
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.4% a rty Sales Disclosure Act".
-I l�.t� eo,-<r4 LThg_
Signature of Seller Signature ofSel
Kim S. Glavich _ _ Mary L Glavich
Printed Name o(Seller Sian Date(MM/DOMIT) Printed Maine of Seller Sian Date(Mk/DD/YYYY)
(F BUYER(S�/,GRANTEEOU'l .P;illai.IQN'lF,OR.PROP,ERT,YCTAX<DEDUCTIONSkiDENTIFYIAL MBMSiTHATtTAMY, -'' ,
Michael R. Duff Mary S. Schneider-Duff
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance docum
309 West Warrick Street __ _ 309 West Warrick Street
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 Owensville. IN 47665
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF TOSE TH T L% U/6
•
YES NO CONDITION YES NO .CONDITION Ci es.
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead �"`�G'Nt)-�"�'
residence? Provide complete address of primary ❑ 0 ;4.Solar Energy Heating/Cooling S3/310x
residence,including county: R
309 West Warrick Street ❑ ; 5.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ Q 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 ❑ Q 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
City,State ZIP Code County /0_l7—I0 • 200 0� /,b 3 OC a
Primary property owner contact name E-mail