HomeMy WebLinkAboutHomestead_Berry (7) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.fPREP,ARER_ r" a .: - - 22 : . da'.__ .�s� s_.`,_s •_. . i s <c _- . , vA_.:s
Patti Kolb Closing Manager
Preparer of the Sales Disclosure Form Title
226 W Broadway St Broadway Title. Inc.
Address(Number and Street) Company
Princeton. IN 47670
E-mail
_E.SELLER(S)LcRANTOR(S) 5 _ .r_;.<3- -_' ,try:_-T_•,.'0
'0 _, L .,. _Late ==7,;ate+..7 `..Tit em 4 w K -. —_ _ r-.
Carolyn Tay or
Seller I-Name as appears on conveyance document Seller 2'Name as appears on conveyance document
_108 S Spring St Apt 6E
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
E-mail Telephone Number E-mall
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and cp�ttplet as required law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
c
Signature of Se er Signature of Seller
Caro n Taylor 2 D
Printed Name of Seller Sian Da a 1MM/D . 'YYY) Printed Nome of Seller Skin Date(MM/DD/IYM
P. B S AP.PLI CAT 10NiEFOR PR PERTY..TAX•DEDUCTIONS_IDENTIFY_ALL ITEMSTHATAPPLY_ __ ___ _ _ I
Myron E Berry ^�
Buyer] ,, rson conveyance document Buyer 2-Name as appears on com•ryancedxume
1018 S Adams St.
Address(Number and Street) Address(Number and Street)
Princeton. IN 47670 Obti%\
City.State.and ZIP Code City,State.and ZIP Code ,Ut
J �wmall
Telephone Number E-mail Telephone Number ?,Un1E-mall
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS OSE THAT APPLY( C)VC11
YES NO CONDITION YES NO CONDITION G1g50N C'
0 ❑ 1.Will this property be the buyer's primary [Ij 0 3.Homestead�
residence? Provide complete address of prima 0 ❑ "Ic , , /sy eating/Cooling System
residence,including county: ❑ ❑
514 N Race St 5.Wind Power Device
Address(Number and Street) 0 El 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ Z 2. Does the buyer have a homestead in Indiana to be 0 B. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 2 9.Would you like to receive tax statements for this
complete address of residence being vacated, pro e r ' contact information
including county: e ow. Please see instructions form 'I Demotion.
• Not available in all counties.)
Address(Number and Street)
Cit.State ZIP Code Co ty
• P(42-i - on - ,Qo lzoa .
Primary property owner contact name E-mall
License/ID/Other Number