Homestead_Bettag INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER2 t> .,, I. .
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
Ciry,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) :?'`
Angela R eolclasure)Mas ter s
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
5136 S Washington Street
Address(Number and Street) Address(Number and Street)
Oakland City IN 47660
E-mail Telephone Number E-mail
Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and//, complete a require b law, d is repared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
' i -(�� � SignatureSeller
Signature Seller ' , l I f^j g of i
Angela R Colclasure Masters l.� ID ay y
Printed Name of Seller Sion Date(MM/DD/YYYI) Printed Name of Seller 1-
rl 45iq' MM/DDM'19]
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL IT S AY APPY.Y, G j
obert B tta
By- 1 tinempears on conveyance document Buyer 2-Name as appears on conveyance do i 5 2018
514 Polk Street
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660 GIHSO Y'AUDITOR
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
2 ❑ 1.Will this property be the buyer's primary ❑ 3. Homestea
residence? Provide complete address of primary U --iii4.3otal nergy Heating/Cooling System
_residence,including county: ❑ ❑✓ S.Wind Power Device
r � 1��5/ /��� DJ S r I6.Hydroelectric Power Device
�dpress(NumberandStreet) \ spit) 0 y
Cr ri177A 7 Riln�n0 �7 ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code ( County
0 0 2.Does the buyer have a homestead in Indiana to be El 0 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 2 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)
A‘ ' ao - O .Z , CeV/— OO ),AOat ."003
City,State ZIP Code County E-mail
Primary property owner contact name
Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security
License/ID/Other Number Number License/ID/Other Number