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Homestead_Brines (3)
YNDIANA SALES DISCLOSURE FORM SDF ID: Page 2 I D PREPARERx4 , ft' -• -..._ -, : ._. . _, Sheri L. Greene Preparer of the Sales Disclosure Form Title 1122 E Ohio St Address(Number and Street) E-mail _E SELLER(S)ORANTOR(S). _ .—.__ . . .... .. _ _..; -,:' _ _. -:__ -._._ _ _ -- Clinton J.Smith Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 2191 W 100 S Address(Number and Street) Address(Number and Street) Princeton. IN 47670 City,State,and ZIP Code City,State,and ZIP Code E-mail Telephone Number E-mail Under enalties of e ' ry,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct an e a �ired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". .......2 Sjgnature`ofSeller` Signature of Seller Clinton J.Smith _—---- _- _ __ 12/ilS�`/2019 (Printed Name Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Siqn Date(MM/DD/YYYY) F BUYER(S)/GRANT_EE(S) _�APPLICATIOI :FOR PRQI?ERTY TAX I)EDUCT.IQ.NS„IDENTIFY,ALL ITEMS THAT APPLY.;:._. . ___ /James Roy Brines - / Buyer 1-Name as appears on conveyance document " • Buyer 2-Nome as appears on conveyance datum--t 612 E State St \ " `\ Address(NumberndStreet ,1 and Street) Address(Number ) °,t,l V I Princeton, IN 47670 \ oec : ! E-mail ! Telephone Number O • '- E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR'FHIS PROPERTY. IDENTIFY ALL OF THOSE TH}tThP''r YES NO CONDITION / YES NO CONDITION NTL may, • 0 ❑ 1.Will this property be the buyer's primary //, IZ El3.Homestead v�OiT. residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling S ygm residence,including county: / / ❑ 0 5.Wind Power Device 612E State St Address(Number and Street) / / ❑ 0 6.Hydroelectric Power Device \ Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device 1 `City,StateZIPCode County ` ❑ 0 2.Does the buyer have a homestead in Indiana to be El 0 8.Is this property a residential rental property? I --vacated for this residence? If yes,provide ❑ WI 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: lbWPlease see instructionsfor- n orm'atigiNi. Not available in all counties.) Address(Number and Street)City,StateZlPCode County aU--\- —o—l.—COL.( bb(-3q `o ~bQB rimary property owner contact name E-mail / Number License/ID/Other Number