Homestead_Bittingham •
INDIANA SALES DISCLOSURE FORM SDP ID: _ .Page 2
;D:'PRPAREW •:Zj1 L _. L”E _ 7, .*• -t 1 '% M1"s I.3C n'!.ym. ._.�,. .1.CW74.g_ -_ •sfii-S'; a _ . 1s -z-'-.l``:I
Regina Rivard Closinc Coordinator
Prep:rer of the Saks Disclosure Form Title
429 Aoollo Beach Blvd. United Title Affiliates, Inc.
Address(Number and Street)
E-mail
_E.sECI,ER(S)/GRANTOR(S) __ :•• 1' r _ , : , . • -ss T q :a - •7_ .. " f P' -- {ic t ' '•re.`: `. ._
The Man=y Source Inc
Seller I-Name as appears on conveyance document Seller 2-Name as appears on convt- .2e me.
500 S..Brad St #1OOA "�7,•�lY�fI
Address(Number end Street) Address(Number an.
Neriden CT O64S0 _ — - _ A _ qQ\q. .-
CLy.State end ZIP Code City.State and ZIP de c s� {Y Ir
Telephone Number E-mail Telephone Number J�[ •l i, s� �� •
E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my kn•wie••6'b�t(Wile',is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Oil.'��,.11es Disclosure Act".
Signature of Seller .Signature of Seller OW
Printed G
Printed Name of Seller Sian Date IMSMna/YYnt Printed Name of Seller Stan Date(Mxfoa 111)
'I BUY! RSl/GIUNTEI(S)-APPLICATIONEFORPROPERTYt,TAX'DEDUCTIONS-•IDFN1IIY/>ALIJ11MGTlAT lPL' _ _
/ rr A Btittmoham I Yvon e A.Bnthnoham -_
\\ Buyal Naremn
appears
on ton veycnce daa:urt JJJ Boyer Name as appears on conveyance document JJJ
Address(Number cad Street) Address-(Number and Street)
Prone i seo jN 4764el Fran 0...f seo zN 4'7.99
S-mm!
THE SALES DISCLOSURE FORK MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION •" NO CONDITION
1
iV 0 1.Will this prope ty be-the buyer's primary ❑ 3.Homestead
residence? Provide complkaddress of primary L IVj 4. o.ar Energy Heating/Cooling System
residence,including county: '
�J y 5.Wind Power Device
Address(Number and Suter) ❑ 6.Hydroelectric Power Device
7.Geothermal Energy Heating/Cooling Device
G ,Sate ZIP Cade County
j ❑ r❑ 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 ❑ Ll 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.
n ties.
Address(Number and Streets �50
a .3
- I '24- I3- OD-/o1- oati8.0 -DD _
[iv StateZIP Code p�I )(p County
s�-Alt_4-L5..e.l"1 �-/V I / t , -- : -v• ..E-,nail
e
INDIANA SALES DISCLOSURE FORM Sill ID: Page 2
D!PREPARER.._-..n(:a'.ru ° 3 t�let: _ t•aesu" ,7 ` n lei3 4-ic:: 1 I__. '•-ram-,-C .e- .=;- a3b?
Regina Rivard Closing Coordinator
Preparee of We Sales Disclosure Fenn Tide
429 Apollo Beach Blvd. United Title Affiliates. Inc. __
Address(Number end Street) Company
Apollo Beach. FL. 33572 (
E-mcii
pE-SEi v.:: • v� . 1., u=«r e . •.. i; -I;?_lr t '.s+Ya:;7 s x era.y; r *iv' •J
LLER($)/GRA\TOR(s) r-n • ->,+ L.s : � ems..;.i_.. r,-- . _., 1 - _. . '- -... e ▪ �.���
The Money SoIMP Inc _ _— - —
Seller; Nate us appears on convevn -d ceeer,neat Sella _ r yx Name ce appea on conmc_:,,unn
500 S Broad S' '100A - .--
Adress(Number and Street) Address(Number and Sweet)
VeridPn CT 0645r
cnwil 1 Telcniu,neNM/Hier - _
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true, correct it
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.S, "Real Property Sales Disclosure Act".
^a> i I
Sgnawre ofSelie - 20'ggq//t\\\���[t - I Sgnatureo SSellerPrint ame ofSeuer Sm On' n, —Printed Name of feller Sian Dare lw>unan nYl
.FIBUYER(S)%GRANTEE(S)=APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIE.Y,AlthillTEMS-THAT:4PPLY, -: ,'.:
Bert A.Brlttincham_- Yvonne A. Brittingham
Bayer I-Name es appear an cancayance document Buyer 2-Name as-appears on conveyance document
Address(Number and Street) ( address(Number and Street)
City,State,and ZIP Code I City,Stare.and ZIP Code --
Telealmne Number E-mail Telephone Number E-mall i
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDmON YES NO CONDITION I
❑ ❑ 1.Will this property be the buyer's primary ❑ ❑ 3.Homestead
residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System I
residence,including county: I
❑ (1 5.Wind Power Device +
— I I
Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device 1
( I ❑ 7. Geothermal Energy Heating/Cooling Device I
C:iv Mate ZIP Code County I I
❑ ,_I B. Is this property a residential rental property?
❑ ❑ 2. Does the buyer have a hon.iestead in Indiana to be vacated for this residence? If yes,provide : ❑ n 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.) I
Address(Number aria Street) , 1
Ciry'State ZIP Code County 1 Primary pruner tyowner contact name cr::ati
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct I
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.) I
I _ I
Signeesre of Buyers Signan:renfUuyer1/Spouse i
i
Printed Legal Name of Buyer i Sian Dare(vnt/oo/1lYf I Printed Legal Name of Buyer 2/Soou:c San D.te t:+vp;o,yf- -
Last 5 digits of Buyer I Driver's State Lust 5 Digits ofSotto!Security Number i Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security I
License/ID/Other Number I Number License/ID/Other Number I