Homestead_Hahn INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Leon C.Stone President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title, Inc.
Address(Number and Street)
E-mail
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Kristine A.Garrett
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
119 N Jackson Street
Address(Number and Street) Address(Number and Street)
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 by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
\--14fi2 -A .Signature of of Seller Signature of Seller
Kristine A. Garrett lta I lip 9
Printed Name of Seller Sign D te(M /DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
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Shaya T.Hahn
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance docu Fm
108 S. Spring Street-Apartment 8B r‘tt
Address(Number and Street) Address(Number and Street) /E_Li
Princeton, IN 47670 DEc 7 ,
E-mail Telephone Number
G/kc,,., • E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAVARL
— UNT,
YES NO CONDITION YES NO CONDITION f .21
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171 0 1.Will this property be the buyer's primary Z n 3.Homestead R
residence? Provide complete address of primary 0 2 4.Solar Energy Heating/Cooling System
residence,including county:
0 0 5.Wind Power Device
119 N. Jackson Street
Address(Number and Street) 1=1 71 6.Hydroelectric Power Device
Oakland City, IN 47660 Gibson 0 yj 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
n 111 0 Z 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 Ej E1 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 ' all counties.)
Address(Number and Street)
City,State ZIP Code County
Primary property owner contact name E-mail i
License/ID/Other Number