Homestead_Mills (2) 1 !
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
.
Leon C. Stone President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title, Inc.
Address(Number and Street) Company
Princeton,IN 47670 (
E-mail
E'SELLE145)/GRANTOrt(S)L'-'1:,: ::.0.i:::,:-'::-.',-:':', :.:-. ,•••;-,,..;,;'-,7.:-::?' '',_e.' :.';•-•,:'''':, •:1;.:1't':--;',:,,W;!-:;:..1; T'-:;-.-_,:.:,,,. •-•::7, ,,-,...:-- ;:i„::'-:::,,;:„.,,,, .,,z-; .„,:l.:: ::.;._:;,,ri,:1,v:4-,,.:..!:::,.f,-;
Donald S Harder Annette C Harder
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
_ 4880 Central Valley Rd 4880 Central Valley Rd
Address(Number and Street) Address(Number one street)
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 co I plet7se„,9 ired law,and is prepared in accordance wit C 6-1.1-5.5,"Real Property Sales Disclosure Act".
deek A4(4tt/DC-17&-/Zi
Signature of Seller Signature ofSeller
f).22,-1(1S Harder .6)9(/`Vi Annette C.Harder /Mh?
Printed Name of Seller Sign Da e(MM/ 0/11111 Printed Name of Seller Sign Date(MM/DIVYYYY)
Ta3T.WER(SVGRANTEE(SY4.APPLIDATION7FOR:PROPERTY TAX:DEDUCTIONS+ADENT1F, `ALL_ITEMSIHAVAPPLY .:.'1`:,.'i':' -:-.'::-:;"-1-..-'.1.-1-,.':'•
Shandal M. Mills
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1025 S. Reisner Street ..
Address(Number and Street) Address(Number and Street) , IT
Indianapolis. IN 46221
BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR T!IS PROPERTY.IDENTIFY ALL OF THOSE THAT APP -
YES NO CONDITION YES NO CONDITION
--(Ai p D 1.Will this property be the buyer's primary 17] E:1 3.Homestead ....n
L'iv0,,„.
ry
residence? Provide complete address of primary D p 4.Solar Energy Heating/Cooling SysaciliDtr0t?
residence,including county:
0 [ ] 5.Wind Power Device
619 W.Emerson Street
Address(Number and Street) El IZ) 6.Hydroelectric Power Device
• Princeton, IN 47670 Gibson D El 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 p 8.Is this property a residential rental property?
: 0 0 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 0 2] 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.)
Address(Number and Street)
. City,State ZIP Code County
Primary property owner contact name E-mail
ID/Other Number