Homestead_Tieken INDIANASALES DISCLOSURE FORM SDF ID: Page 2
Timothy Shea Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
•
, ',;7:-iY "k - i ,„ )L. `,.. .wa -"} K....: _ f 4 °., ik t -P- -+-Tni =,11.r r-ojl i �-„ -_.- __ y M i j
Matthew W.Deputy
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
3297E 50 S
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670
.
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 by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller 47147— Signature of Seller
Matthew W.Deputy (` i11� b
Printed Nam Sign Da (M i D D/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
WiBul-RR S IORMITEEfS ,PLICAT.IONVONPROPElrrVTAX.bEbUCT,I'OT1S -IDENTIFYIALI,SITE f§TfkiWRI;Y�� "`T`.
7oshua Matthew Tieken -
I eyance nt Buyer 2-Name as appears on conveyance document
dress(Number and Street) Address(Number and Street)
p35,9, sago e 1
FILED
Telephone Number E-mail Telephone Number E-mail
14 2019
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P ERTY.IDENTIFY ALL OF THHM THAT APPLY. Novo /_�
YES NO CONDITION YES NO CONDITION IJ��+w•',;'•�J�
❑ 1.Will this property be the buyer's primary (ICK 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary 4. o gy Heating/Cooling System
residence,including county: El Q 5.Wind Power Device
3297E50S
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Princeton,IN 47670 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State Zp(de County El ["8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide ❑ Q property via - (P contact information
complete address of residence being vacated, b lease see instructions form • ormation.
including county: Not available in all counties.)
Address(NumberandStreet) 2 6-12-15-200-000. 2 9 5-02
Joshua
City,State ZIP Code County Primary property owner contact name E-mail
Number License/ID/Other Number