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Homestead_Thomas (22)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 W.P.REPARERt vo Y r Q R=h x _ n r d;.i Rexanne McCauley Title& Escrow Processing Preparer of the Sales Disclosure Form Title 3930 Mezzanine Drive. Ste C Columbia Title. Inc. Address(Number and Street) Company Lafayette, IN 47905 ,E+SELER(S GREN)TOR gcr7 E_- -7 --- -- . Is, __ _ '_� .�. �� 5�3 •v -� �s ,,—s— s.r la -'-7'-yam-j Liza J Grubb Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 10 I S C 9-c1-,5or. S-t Address(Number and Street) Address(Number and Street) ?tint e_-1-a-• .fJ 4 -16'76 City,State,and ZIP Code City,State,and ZIP Code $ 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 6-1.1-5.5,"Real Property Sales Disclosure Act". 5 ^ l e fSel -e Signature of Seller I isa,l Grubb -1 -I I - I Printed Name of Seller Sian Date(MM/DD/ V) Printed Name of Seller Sian Date(M.M/DD/YYYF) LF:.BUYERNYGRAN__TEEISi=AP,BLICATIONiEDRPROPERTA TAXED.EDUMOIK'SflInT.IFYALL+1T.EMSLTHATiAPPLY Amber D.Thomas Cynthia Smith Buyer 1-Name as appears an conveyance document Buyer 2-Name as appears on conveyance document 109 Central Avenue 109 Central Avenue FILED Address(Number and Street) Address(Number and Street) Princeton, IN 47670 Princeton, IN 47670 City;State,and ZIP Code BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APP YES NO CONDITION 1 YES NO CONDITION W'I 0 ❑ 1.Will this property be the buyer's primary iZi ❑ 3.Homestead GIBSON COUNTY AUDITOR residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 109 Central Avenue ❑ ❑✓ 5.Wind Power Device Address(,Number and Street) ❑ IZI 6.Hydroelectric Power Device Princeton ,IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZlP Code County ill ,Jj 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 ❑ 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: below. Please see instructions for more information. Not available in all counties.) Address(Number and Street) a6 - 1a-18- Soy- Oa. ?ai-Oa?Si City,Stare ZIP Code County Primary property owner contact name E-mail