Homestead_Michel (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D._PREPARER--- _ - -
Patti Kolb Closing Manager
Preparer of the Sales Disclosure Form Title
226 W Broadway St Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670
E-mail
O/ • --
E.SELLERS ' GRANTOR(S)
Nicholas W Michel
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2801 W Soybean I N
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648
City,State,and ZIP Code City,State,and ZIP Code
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 bya is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
YLl�`�r+t' A.,
Signature of Seller
Nicholas W. Michel i0L
Printed Na er on Date(MM/DD/YYYY) Prut e Sign Date(MM/DD/YYYY)
F TR(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTI
ONS—IONS—IDENTIFY A. ._ S THAT AP".Y •
/ Matthew B.Michel Kassie L. Michel
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance docume
2905 E 100 N 2905 E 100 N
Address(Number and Street) Address(Number and Street)
-ILE t'
Princeton, IN 47670 Princeton, IN 47670
City,State,and ZIP Code City,State,and ZIP Code 0C
'� O1j E-mail
T SCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPE• r - -• • - _ OF TE144 `r; Y:
—.._I
YES NO CONDITION NU CON I H C UN� 1./
0 ❑ 1.Will this property be the buyer's primary IZI ❑ 3.Homestead - rYq(Joi
residence? Provide complete address of primary , oar nergy Heating/Cooling Syste0?
residence,including county: ❑ 0 5.Wind Power Device
2801 W Soybean LN
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑✓ 2.Does the buyer have a homestead in Indiana to be El8•Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 171 9. 'ke to receive tax statements for this
complete address of residence being vacated, proper e-mail. ontact information
including county: below.Please see instructions oration.
Not available in all counties.)
Address(Number and Street) CO ' f
City,State ZIP Code C��\8- LA-LkCO- we.�0D-N. 'a 1
er contact name -mail