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Homestead_Wheeler Jr INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER 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.SELLER(S)/GRANTOR(S) Kevin DeJarnett Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 2395W100N Address(Number and Street) Address(Number and Street) Princeton IN 47670 City,State,and ZIP Code City,State,and ZIP Code ( perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct aro plete required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seller Kevin DeJarnett Printed Name of Seller Si Date{ /DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT James W.Wheeler.Jr. (, Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 2429 W 100 N Address(Number and Street) Address(Number and Street) T� Princeton, IN 47670 0 E-mail Telephone Number (/ E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. )— YES NO CONDITION YES NO CONDITION 0/, ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead OR residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System residence,including county: ❑ 2429 W 100 N 5.Wind Power Device Address(Number and Street) ❑ z 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property? vacated for this 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 contact information including county: /1 e'to err below. Please see instructions for more information. �� P Not available in all counties.) Address(Number and Street) City,StaleZlPCode County ^11-Q a -300 -0 0 l ��-��� Primary property owner contact name E-mail Number License/ID/Other Number