Homestead_Lester INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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D PREPARER _£.- n b oe1 - -�-+- �''4:7 {"`'- -' ` '�
1 _Leon C. Stone _ President
Preparer of the Sales Disclosure Form Title
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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
OMELLER(S)//,GRANTLOR(S)) .. . . zA''k-tI '.tkt.4. ~„_ --. . - r ti - ;
Mary S. Reneer -
Seller 1.Name as appears on conveyance document Seller 2-Name as appears on conveyance document
• 2400 E I ake Road
•
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
E-mail Telephone Number E-mail
Under penalties of perjury ereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and o plete as re uiret b, :w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signal a of Seller / Signature of Seller
/ ���
Mary S Renee /
,Printedreame 'illeT� Slur'Date(HH Domno Printed Name of Seller Sian Date(MM/DD(YiW)
afi?iBU,YiE tIMGRANTIES(S), ABBLIGATION F,ORIRRO IERTIYOAX DED.l1CTilONS-ID.ENITIFY ALL IIMEEMS THAT AP,P,LY :r >*7;� -T+==1
A . Lester p I `
DE
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Buyerl-Name as rson conveyance document Buyer2-Nameas appears on con ace en[
c F ) g1_3 Col ig9-eA-+/e
Address(Number and Street) -/ �7 Address(Number and Street) DECy j o�O�o
•
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USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL UF'THDSETHATA9PL4.Y MUD'I UN
YES NO CONDITION / NO CONDITION
❑ ❑ 1.Will this property be the buyer's primary / 0 ❑ 3. Homestead
residence? Provide complete address of primaryt (—I 11 a Solar Energy H . g/Cooling System
residence,including county: • ��' __J'�.'}�5 . owe r Device
701 S Stout Street
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson 0 Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 Z 2.Does the buyer have a homestead in Indiana to be 0IZI
8.Is this property a residential rental property?
vacated for this residence? If yes,provide 0 2 9.Would you to_receive tax statements for this
complete address of residence being vacated, property via e-mail?(Proviide c nta t information
including county: below.Please see instructions for more.inf\n.
Not available in all Counties.)
Address(Number and Sweet) I �- e_D-/2-07 zioY_ C0,2 _ 1/97-D2 _
City State ZIP Code unry L o��J\
Primary propertyawner contact name L+nml.... .... -
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowle gad 1�elief,is true,correct
Number License/ID/Other Number