Homestead_Barrett (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D1 AEPARER
Leon C. Stone President
Preparer of the Sala Disclosure Form Tide
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
$ETSELLER(S)%GRANT,OR(Sraree `��f5 :'
David W McDonald - Dee Anna McDonald
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
652 S Ellsworth Rd, Lot 10 652 S Ellsworth Rd. , Lot 10
Address(Number and Street) Address(Number and Street)
Mesa, AZ 85208 Mesa, AZ 85208
E-mail
Under penalties of perjury,)hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and
c plete as required/. by is prepared in accordance with IC 6-1.1-5.5,"Real ro ere Sales Disclosure Act".
i,'W
le. (W_1 no. ' TV wicall' C`
Signs ure of Seller Signature ofSeller
David W McDonald I ? - I O- 1 g aA Anna McDonald IA I i()
Printed Name of Seller Sian Date(MM/DD/YYYI) Printed Name of Seller Sian Date(HN/DD/YIYI)
°F;B YAPP.LICATION_F.ORTPROPERTY411A7DEDUCTION filDENTIEYALI3lTEMSyppTH�AT/APPCY, % . _ 'f
Nicholas J. Barrett yp�-4 r7 U i`
B I-Name as a pears on cony document Buyer 2-Name as appea}Lan convey$nce?!¢_h{ta)e(+tII
r S" C�
dress(Number and St: r7 Address and Street) DEC 1 / 2018
bV
FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. I LL OF THOSE THAT APPLY.
YES NO CONDITION /YES NO /CONDITION
ge ❑ 1.Will this property be the buyer's primary 3.Homestead
residence? Provide complete address of primary II .Fr 4. oar nergy eating/Cooling System
residence,including county:
❑ 0 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State 9P Code - County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.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: ..0 Please see Ins or more information.
Not available in all counties.)
•
Address(Number and Street)
2,6-1 5 z0 300 -co 00 . -k - r—
City,State ZIP Code r,unty
Primary property owner contact name E-mail
Under
Number License/ID/Other Number