Homestead_Skipworth INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER . . - _ -
Britany N Barnes Agent
Preparer of the Soles Disclosure Form Title
226 W Broadway Broadway Title, Inc
Address(Number and Street) Company
Princeton, IN 47670
City,State,and ZIP Code Telephone Number Email
E:SELLER(S)/GRANTOR(S)
Twilla McConnell
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1054 S Old SR 65
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
Cory,
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 nd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
L? e
Signature of Seller Signature of Seller
q
Twilla McConnell p-'0,27—/7
Printed N ret'YFRTr' --- Sian Date(!LN/DDATT}t Printed,Name of Seller ate t.H.mowim
YER(S /GRANTEE SN APPLICATION FOR PROPERTY:TAX DEDUCTIONS=IDENTIFY ALL ITEMS THAT
Timothy .Skipworth Ann M Skipworth
Buyer l-Name vsappen vey' ce document Buyer 2 Name as appears on conveyance dd�� et.
202 W 8th St �
O�j
lN2 ynr Rrl, �r
Address(Number and Street) Address(Number and Street) r- y O\-S°�V
Monroe City. IN 47557 Monroe City, IN 47557 ( \S
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. I t": NO CONDITION
' HOSE THAT APPLY. �C7O
YES NO CONDITION I G\
—
❑✓ ❑ 1.Will this property be the buyer's primary I ❑✓ ❑ 3. Homestead
residence? Provide complete address of primary � li ❑✓ 4.Solar Energy H- mg/Cooling System
residence,including county: Wins 1054 S Old SR 65 211 12 5.�'l ns Power Device
Address(Number and Street) ❑ ❑✓ 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ El 2. [18. Is this property a residential rental property?
2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide ❑ g 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. see instructions o information.
available in all counties.)
Address(Number and Street) II -4-'1
�7 U,{� t_,}t' �)
City,State ZIP Cade — 4-I -4 l L`�l_V - 00 ` .sq� 1/
County
ninary property owner contact name E .ail