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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Patti Kolb Closing Manager
Prepare of the Sales Disclosure Form Title
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226 W Broadway St ,. Broadway Title,Inc.
Address(Number aad Street) Company
Princeton,IN 47670 • 812-386-1687 oatti.btithmw.twcbc.com
City,State,and ZIP Code Telephone Number E-ma0••
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?E-SELLEl EWItTaNTOR(S)L l •y .i:: -••.:: ,•-ti-"e' - . . r • u ..
Lloyd F .Zones
Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document
722 Highland Ave
' Address(Number and Street) Address(Number and Street)
Oakland City IN 47660
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and omplete as re uired by law,and is prepared in accordance with IC 6-1.1-5.S,"Real Property Sales Disclosure Act".
• S{grmeu af5elle / c Signature of Seller
• I Inyd F .Ines g/�o J i O
_ Pitted Name o Seller clan Dote MM D/YYYYI Printed Name of Seller -Sian Date(MM/DD/YYYI)
FaBU;Y:ER(:S)S/,G R?4i\ITE£(S S TARP,LIGAMIDNaF,QRIRRQPERTtYL•TAX4DEDUCTI9.NS IDENyTIFeWAIII ITEt;1SPIi.HrATMITLI ' =s 44-- 1
Robert Gavle WtISOft) $It
Byer I-Name as appearson conveyance document Boyer 2-Name as appears on Co me Qp[ ED
• 219 N Mulberry St • 111 A Jyyy�S����J,
• Address(Number and Street) Address(Number and Street)
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• THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDFNTIFYALL QFTF105PItIlA % YY AUDI FOR
YES NO CONDmON I YES NO CONOmON
❑ 1.Will"this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
residence,including county:
?79 N Mulherry Sf ❑ Q 5.Wind Power Device
Address(N amber and Street) ❑ Q 6. Hydroelectric Power Device
Oakland City. IN 47660 - ❑ Q 7.Geothermal Energy Heating/Cooling Device
Ory.State 2IP Code County
❑ Q 2. Does the buyer have a homestead in Indiana to be ❑ Q 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)
Gry.State ZIP Code County 14-18 3oa-ood3ss-0°7
Primary property miner contact name E-mail
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