Homestead_Velthouse / .,
JANA SALES DISCLOSURE FORM SDF ID: Page 2
IPREPARER•
/Britany N Barnes Agent
/ Preparer al the Sales Disclosure Form Title
226 W Broadway Broadway Title, Inc
Address(Number and Street) - Company
Princeton, IN 47670 1 812-386-1687 I Britany@Broadway-Title.com
City Smte,and ZIP Cade I Telephone Number ' I E-mail
E.SELLER(S)/GRANTOR(S) '
L.S.M. Investments,LLC
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
280 E Old Petersburg Rd,
Address(Number and Street) I Address(Number and Street)
Princeton, IN 47670
City.State,and ZIP Code City.State,and ZIP Code
(
Telephone Number 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 required b��yrr law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signora [Seder y� Signature of Seller
Larry Shane Matthews 3 -6 '/9
Printed Name ofSeller . Sian Date(M.M/DDMTY) Printed Name of Seller Sian Date(MN/oo/ITI))
E(S)-APPLIC 7 PR XDEDUCTIONS- IDENTIFYALLITEMSTHATAPPLY'
Noah B Velthouse Paige J Velthouse
urn.-.n....r on conveyance datvme.. Buyer 2-Name as appears on conveyance document
310S Hart St 310S Hart St .
Address(Number and Street) MART2-Z119 Address(Number and Street) .
Princeton,IN 47670 Princeton, IN 47670
THE SALES DISCLOSURE FORM MAY DE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. I L OF THOSE THAT APPLY.
YES NO CONDITION NO CONDITION
❑✓ ❑ 1.Will this property be the buyer's primary ❑✓ ❑ 3. Homestead
residence? Provide complete address of primary ❑ 2 4.Solar Ener ' g/Cooling System
residence,includ' g county:
4n/ Gl y/b jLC r ice
Address(Number and Street) I ❑ ❑✓ 6. Hydroelectric Power Device
Princeton, IN 47670 a
/��-0 ❑ ❑✓ 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
[✓� ❑ 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 ❑ ❑✓ 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail? Provide contact information
�?el�ud�ing co v. Please see instruction re information.
31 0 S. /T/t7- an Not available in all counties.)
Address(Number and Street)
Princeton, I
idce(n, IN 47670 al moo l -12 _ O1 _'O, - V OJ • DV I^ -0
City.State ZIP Code County
rumor•property owner contact name Email
Under penalties of perjury,I hereby certify that this Sales Disclosure,