Homestead_Holderbaugh INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
DAPREPARER > i -0_`_ _ _.'v -- -T . .1^ _- " Tar/IA:it ,M, .t ''n- - _;:PS' z
Leon C. Stone President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title, Inc
Address(Number and Street)
jai _ ,_- '.rfn +_-t.-..,jcr.-S:S,...
Weber Investments LI C
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1017 W 150 N
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
City,State,and ZIP Code City,State,and ZIP Code
(
Telephone Number 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
a complete as required by law,,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
nm D Ot�I �l ( .�w`E X1
Signature of J i�1 js Signature of Seller
Pamela-K Weber CCCJJJ _ I"'� (1lt/I
tented Name of Seller \ Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
.EUYER(S)/GRINTEE(S):=.APPLICATION FORPROPERTYJAXDEDUCTIONS—_IDENTIFYALLITEMSTHAT'APPLY '-__ _-__-
Millette Holderbauoh
Buyer I-Name as ap conveyance document Buyer 2-,Name as appears on mnveyancedoc
. em ry Street
Address(Number and Street) Address(Number and Scree
Princeton, IN 47670 p
lSEP 1 L
Telephone Number E-mail Telepl>enikumber \
a % E-mail
le
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THISPROPERTY. IDENTIFY ALL OF THOs THA ,III
YES NO CONDITION /I YES NO CONDITION t I AUDITOR
SSU/4 COUNT
0 ❑ 1.Will this property be the buyer's primary (/ El ❑ 3.Hom �a
residence, Provide complete address of prim.Solar Ener mg/Cooling System
residence,including county:
302 W Third Street -+ldi7f"dwer Device
Address(Number and Street) ❑ IZI 6. Hydroelectric Power Device
Patoka. IN 47666 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,Stare ZIP Code County
IZ
❑ 0 2. Does the buyer have a homestead in Indiana to be ❑ B.Is this roperty a residential rental property?
vacated for this residence? If yes,provide ❑ .Would you like to rec ' tax statements for this
complete address of residence being vacated, property via e-mail?(Provi ntact information
including county: below. Please see instructions for re information.
Not available in all counties.) 0 Z°.
Address(Number and Street)
b - Qt- zr - (0\ - pto- 2I0 -
Lay,State ZIP Code County
nmaty propertyowner coma / E-mail
Number License/ID/Other Number