Homestead_Terry INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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D.PREFARER+ice' - K, ..lL L t ' i;= ' t c!c
Leon C. Stone . President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title. Inc_
Address(Number and Street)
E-mail
.Ei;SELL''EjS]/GRANiTOR(S) - n e : ...Th.;t- "-` -- -- _ A ;sr,_• _; , _ i.;.>, ` . t ._-
Brian I Terry Patty S Terry
Seller I-Name as appears on conveyance document Seller 2•Name as appears on conveyance document
1027 S Stormont Street 1027 S Stormont Street
Address(Number and Street) Address(Number and Street)
Princeton IN 47670 Princeton IN 47670
City,State,and ZIPCode City,State,and
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 quired by law,and is prepared in accordance w• C 6-1,1-5.5,"Real Property Sales Disclosure Act".
Signature of Se lei f 9 nat o Seller 0
Brian L Terry Patty S Terry
'ame of Seller Sian Date FALN/DD/YVn') Printed Name of Seller Sian Date F.N.M/DO/YTYY)
.:BUYER(S , RANTEE(Syf'APPLICATION.FORTROPERTYTAXDEDUCTIONS_.IDENTIFYALC,ITEt • L ' Pt .._-
Bradle Ter 2 1LJp
:uyer I-Name as ap -•rs on conveyance document Buyer 2 Name as appears on conveyance m
500 r' +arno -Trailer D3 ((�� 0 2�19
Address(Number and Street) Address(Number and Street) AUG 2
Princeton. IN 47670
E-mail roneNumber
GIBSOIJ COUNTY PUDITOREmailTHE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR FY ALL OF TI SE THAT APPLY.
YES NO CON
• be the buyer's primary Z ❑ 3.Homest d
c :7'7 _
esidence? Provide comp e Tess of primary 4.Sala nergy Heating/Cooling System
residence,including county:
nt Street ❑✓ 37Wind Power Device
nd Street) IZI 6.hydroelectric Power Device
47670 Gibso ❑ Ej 7.Geothermal Energy Heating/Cooling Device
e County Does the buyer have a ho n Indiana to be ❑ ❑� 8.Is this property a residential rental property?
v r is 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 contac ' rmation
including county: ns rl flan.
Not available in all counties.)
Address(Number and Street) (� o
City,State ZIP Code County �r �G -�a— —.-.L _ l AJ( . V�-oa0 •
Primary property owner contact name E-mail
Number License/ID/Other Number