Homestead_Smith (80) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER <£
Antrese Card Deed Specialist
Preparer of the Sales Disclosure Form Title
562 Woodward Ave. Amrock Inc.
Address(Number and Street) Company
Detroit, MI 48226 888-848-5355
City,State,and ZIP Code Telephone Number E-mail
Ei";SELI:ER(SyGRANTOR(S)$! , , , _< :' .:.,.e;:,r„E , „ ...;: : :..-,,;:,M ,
Heber Keith Smith Janet Elaine Smith
Seller! -Nameas appears on conveyance document Seger 2-Name as appears on conveyo a document
504 Harding Ave i Ott /fprdrl y. svP.
Address(Number and Street) Address(NumberL� and� Street
Princeton, IN, 47670 Q,",heelrn, �A" 97b717
Under penalties of perjury,I hereby certify that this Sales Disclosure, to the best of my knowledge and belief,is true,correct
and� in ete as e 'r by v,and is prepared in accordance with IC 6 1.1- - .5,"Real�p�]7_�ope�rty s les Disclosure Act".
/V -/d jzL, t(,
Signature ofSelle nature of Seller
Heber Keith Smith /0 -/' ./r ane�e Smith JO—/ti-o20/0P
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F -BUYER(S)/GRANT£E(S) =APPLICA`f'IDN ORTROPERMTAX,DEDLICTIONSgDENTIEVAI LPfEM THATAPPLY;Yt ...
Kimberly Smith
Bvyerl -Nameasappears on conveyance document Buyer 2 -Name as appears on conveyance document
1505 Mary Lee Dr
Address(Number and Street) Address(Number and Street)
Princeton, IN,47670
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFYALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
® ❑ 1.Will this property be the buyer's primary Ls 0 3.Homestead
residence?Provide complete address of
prima residence,including county: ❑ 0- 4.Solar Energy Heating/Coaling System
/so ? Mafb- zee DR ❑ a 5.Wind Power Device
Address(Num e•and Street) ❑ ❑r 6. Hydroelectric Power Device
t wpm,, Purr _ 6270 O-.65 ❑ Q- 7.Geothermal Energy Heating/Cooling Device
City,State ZIP .•e County
❑ 0 [r 8. Is this property a rental property?
al 2. Does the buyer have a homestead in Indiana to be
vacated for this residence?If yes,provide ❑ a 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)
26-12-08-104-003.024-028
City,State ZIP Code aunty Primary property owner contact name E-mail