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Homestead_Dyson IND ANA SAES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER T_.�� �_.� _____.» _^_______-_�-._.__ _ ___ Britany N Barnes Agent Preparer of the Sales Disclosure Form Title 226 W Broadway Broadway Title, Inc Address(Number and Street) ___.___.___ Brian Taylor Dolly Taylor Seller I•Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1.7iS5 H5g,-)e iA-a c- t c- , os -k D C Address(Number and Street) Address(Number and Street) , Under penalties of perjury,I hereby cert' - this Sales Disclosure,to the best of my knowledge and belief,is true,correct an omp.l e as require aw,a.- is pre... • i in accordance with -1.1-5.5,"Real Proper Sal Disclosure Act". ....ic , 04/:42 t i Signature of SiT Ica• T Signature of Seller Brian Taylor Dolly Taylor Printed Name of Seller Sign Date(MM/D/YYYY) Printed Name al-Seller Sign Date(MM/DD/YYYY) (F R(S)/G E(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY Y ALL ITEMS THAT APPLY Marjorie A.Dyson Steven W.Dyson lJuye- ears on conveyance document Buyer 2-Name as appears on conveyance document 607 E State St .41.6 N Gibson— Gil41(7 sties 6Ap. A - Address(Number and Street) Address(Number and Street) Princeton, IN 47670 Princeton, IN 1?-&20 Cathay- J/V W U 3 E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROP . ENTIFY ALL OF ' AT APPLY. YES NO CONDITION YES NO CONDITION ❑✓ D 1.Will this property be the buyer's primary ✓ ❑ 3.Homestead residence? Provide complete address of primary U kJ 4.solar nergy eating/Cooling System residence,including county: 607 E State St ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ ❑✓ 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 02.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 ❑ ❑✓ 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 in all counties.) Address(Number and Street) City,State ZIP Code County IN1 ANA SALES DISCLOSURE FORM SDF ID: Page 2 D. PREPARER Britany N Barnes Agent Preparer of the Sales Disclosure Form Title 226 W Broadway Broadway Title, Inc Address(Number and Street) E.SELLER(S)/GRANTOR(S) Nikki Taylor Seller I-Name as appears on conveyance document. Seller 2-Name as appears on conveyance document lc 356 •il mr%c - -\'', Address(Number and Street) Address(Number and Street) 6-1.1-5.5,"Real Property Sales Disclosure Act". Si nature ofSeller Signature of Seller Nikki Taylor P re o Seller Sion Date(MM/DIVYIT') Printed Name of Seller `I t (M.M/pror y) , l;R f NTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY-ALL IT y .7 Slily • Marjorie A.Dyson Steven W. Dyson layer I•Atune as appears an conveyance document Buyer 2•Name as appears on conveyance daµirpe 3 0 2 19 607 E State St 316 N Gibson UUtt Address(Number and Street) Address(Number and Street) Princeton, IN 47670 Princeton, IN 47670 • City,State,and ZIP Code City,State,and ZiP Code GIBSON COU AUDITOR r E-mail mne Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR IS PROP IDENTIFY-ALL-OF-THOSE-T-HA-T-A Y. YES NO CONDITION //! NO CONDITIbN� ❑✓ ❑ 1.Will this property be the buyer's primary/ ❑✓ ❑ 3.Homestead dd residence? Provide complete address primary --. ❑ ❑✓ 4.Solar Energy Heating/Cooling System residence,including county: ❑ El 5.Wind PowerDevice 607 E State St Address(Number and Street) ❑ ❑✓ 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ; ❑ E 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code I County El 02.Does the buyer have a homestead pi Indiana to be ❑ 8 Is this property a residential rental property? vacated for this residence? if yes,provide ❑ ❑✓ 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 in all counties.) Address(Number and Street) \ 1 _ \ 026, . /x+ o7 , XOy - av ;, y�_v a$ 1 City,State ZIP Code , County L Primary property owner contact name 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".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed.) Signature of Buyer] Signature of Buyer2/Spouse Marjorie A. Dyson Steven W.Dyson I Printed Legal Name of Buyer I Sign Date(MM/DD/YYYV) Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YYYY) Last 5 digits of Buyer 1 Driver's State Last 5 Digits of Social Security Number Last S digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security License/ID/Other Number Number License/ID/Other Number 2 2