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Homestead_Fogg
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 10gP,REP,IRER4ae y 4 Leon C. Stone President Preparer of the Sales Disclosure Form Title • 226 West Broadway Street Broadway Title. Inc. jAddress(Number and Street) Company Princeton, IN 47670 (812)386-1687 City,State,and ZIP Code Telephone Number E-mail jEFMTIER(SAGRAN:T,OR(S) is -:. '- ' s rti``i T',"'..-t:' --54 a.x'x-'''" ` ; Paula C Elpers S lie/z.I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document o, c ) x LJ Address(Numbe and Sjreet) Address(Number and Street) � }hsv, li e_ ►� +771 X . 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 and complete as required by law,and is prepared in accordance with IC 6.1.1-5.S,"Real Property Sales Disclosure Act". 0� &‘ *re- - Printed Name of Seller Sian Date(MM/DO/YrrY) it ER(S)%GRAN)ance F E --B ymas Vm. F..g Duo asappea document Buyer2-Nameasappearson canFic eatatr g� ED Address(Number and Street) Address(Number and Street) Princeton, IN 47670 JAN 3 9013 - E-mail Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO ROPERTY. IDENTIFY AL SE TY AUDITOR YES NO CONDITION YES NO CONDITION GI 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4,Slat it eating/Cooling System residence,including county: 707 East Water Street ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ g 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ ❑`/ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Z 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) 2 `C/ — p City,State ZIP Code County l z- ^7 —�Z _CM. ��-D2 Primary property owner contact name E-mail Number License/ID/Other Number