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HomeMy WebLinkAboutHomestead_Mizeur • INDIANA SALES DISCLOSURE FORM SDP ID: Page 2 DSIPREP;ARERi r„ _ _ w a .T'o •w:,' -a - <.- Leon C. Stone President Preparer 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 ZIP Code Telephone Number E-mail [SEEEER(S)%GRANTOR(S)) . _ r--7-7-7 f. :.n'y;-- —.-- -- ---= Dawn Renea Kroeger Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 3207 N SR 61 Address(Number and Street) Address(Number and Street) Petersburg IN 47567 . E-mail Telephone Number E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct an omplete as quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". X r.t,t (fu lrA .e--(tyt......, Signature of Seller (( ,/ Signature of Seller Dawn Renea Krneger II " J i' 1 J Printed Name or Seller Sian Date(MM/OD/YfY) Printed Name of Seller Sian Date(MM/D0ryY11) (Fc;B[1YER(SVGRAN7TEE(S�,_rAP.P.t:IGOIONW,,ORR OP,ERViTAXWEDUGTIQNSLIDENTIFI'Fika;ipiEM5T!HAT:AP,P,EY% . — , . _Brag -N T. Mizeur I Buyer -Name as appears on conveyance document Buyer 2-Name as appears on conveyance doc • 541 S Concord Drive r Address(Number and Street) Address(Number and Street) i Princeton. IN 47670 A/QVi 1 ����p • City,State,and LPCade City,State,and ZIP Code 9 201p( USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF TFN52 �gMNMqPA7 • .YES NO CONDITION YES NO CONDITION Wti's1Y OU�)T`/,n,,.. • oR • Q ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead JU)F residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 9376E 300 S ❑ 2 5.Wind Power Device Address(Number and Street) 0 III 6.Hydroelectric Power Device Oakland City, IN 47660 ❑ IZI 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 2.Does the buyer have a homestead in Indiana to be El8.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) / j // City,State ZIP lode County107 �f e1 —C71 2—men— Cal 590 -�� Primary property owner contact name E-mail Number License/ID/Other Number