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HomeMy WebLinkAboutHomestead_Zakrjewski INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER - . - . Briiany N Barnes Agent Preparer of the Sales Disclosure Form Title 226 W Broadway Broadway Title, Inc Address(Number and Street) Company Princeton, IN 47670 • 812-386-1687 I Britany@Broadway-Title.com City,State,and ZIP Code Telephone Number E-mail E.SELLER[S)/GRANTOR(S) ' Travis J Miller t Seller l-Name us appears on conveyance document Seller 2-Name as appears on conveyance document1.I 121W Mulberry St �� Address(!:umber and Street) Address(Number and Street) Vi Princeton, IN 47670 p p\9 E-mail Telephone Number \'(Maui! Under penalties of-per-jury, I hereby certify that this Sales Disclosure,to the best of my knowledge a I aks(true,correct and com el tiered by la% . d is prepared in accordance with IC 6-1.1-5.5,"Real Property s ag>absure Act". �� �.; G\gSpN I , Signature of Seller tll-r 0/Ab A0(1 Printed Name of Seller Sian Dote(AIM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/)7»T F.'BUYER(S)/GR(ANTEE(S).`'APPLICATION:FOR,PROPERTYTAXDEDUCTIONS-.IDENTIFY.ALLITEMS•THATAPPLY' =`•-`,= - I .:,-'....• Brittney E Zakrjewski , Lisa A. Sinkhorn Buyer l-Name as appears oh conveyance document Bur/2-Name as a➢➢e;(�an ronve,vo document $gill S Deer N/.vttn Dr i ,[i- �)Le�o At A . Address(Number and Street) Address(Number and Street) Princefen IN 47u70 'P, , � 4l&,yd BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION � YES NO CONDITION ❑✓ ❑ 1.Will this property be the buyer's primary ❑`' ❑ 3. Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ 121 W Mulberry St 5.Wind Power Device Address(Number and Street) ❑ g 6. Hydroelectric Power Device City State ZIP Code County ❑ ❑� 7.Geothermal Energy Heating/Cooling Device ,� ❑ ❑'' 8. Is this property a residential rental property? ❑ h 2.Does the buyer have a homestead in Indiana to be vacated for this residence? If yes,provide ❑ O 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) 1 Q 1■^, AddCayress Stat ZIPCo e County a t" —,a — on— �- 0�.0 1 10 Primary property owner contact name E-mail