Homestead_Przymus (2) INDIANA SALES DISCLOSURE FORM SDF ID: Pa•e
I-D PREPARER
Steven L.Whitehead ------Attorney-- - � - �---- — --- --� --- ------- --
Preparer of the Sales Disclosure Form Title
111 N. Hart Street
Address(Number and Street)
E-mail
E SELLER S,',GRANTOR S — — — _
Samuel T.Przymus
Seller 1-Name as appears on conveyance document Seller.2-Name as appears on conveyance document
20‘S i St-cL-e ( 4,tt
Address(Number and Street) Address(Number and Street)
?.,a, e e -bi kt LI-7(a7O
of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sates Disclosure Act".
-
Signature of Seller • Signature of Seller
Samuel T PrzymaLa- i o/2 / Di7
Printe, r —, Si n Date(MM DD/IYIT) Printed Name o Seller Sign Date(MM DD "VYYI
BUYERS GRANTE C APPLtIGATIOIVI-FOR PRORERTY T4(inD-U-CTIONS=IDENTIFY ALL Li Q AT PPLy_ ____
Angela D. Prz mus �,�� ■
Buyer 1-Name as appea on . eyance document : K 3—
Buyer2-Name as appears on cony•r: ce:Mg..'-
•I o nson Avenue
Address(Number and Street) Address(Number and Street) N 0 V 01 2019
Princeton, Indiana 47670
E-mail Tele,hone Number IBSON COUNTY AUDIT. E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P•a'-' '• . : m, , L OF THOSE THAT APPLY.
YES NO CONDITION Aill YES NO CONDITION
❑✓ ❑ 1.Will this property be the buyer's primary ❑✓ ❑ 3.Homestead
residence? Provide complete address of prima .1w['I , olar Ener_a ._•, -'rig/Cooling System
residence,including county:
607 Johnson Avenue ❑ ❑✓ 5.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ ❑✓ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
Li ❑✓ 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 ❑ Q 9.Would you like to receive tax statements for this
complete address of residence being vacated, s r$•• . - - •• . . a 'de contact information
including county: below.Please see instructions for : - information.
Not available in all counties.)
Address(Number and Street) '
26-11-o$ - 203-oo�z . z66 -oza .
License/ID/Other Number