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Homestead_Rodgers (2)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D..PREPARER . . , . Leon C. Stone President Preparer of the Sales Disclosure Form Title 226 West Broadway Street Broadway Title. Inc. Address(Number and Street) Company Princeton, IN 47670 ( E-mail .SELLER(S)/GRANTOR(S)_ . , : 5 - Cheryl Ann Hollingsworth Shaun Hollingsworth Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 2270 Fast Top Hat Road 2270 Fast Top Hat Road Address(Number and Street) Address(Number and Street) Princeton IN 47670 Princeton- IN 47670 and belief,is true,correct and completerequiredre by law,and p pre accordance with IC 6-11-5.5 "RealProperty Sales Disclosure Act". a_ed Signat a of Seller / Signa r of Seller Sheryl n Hollingsworth /? vp/ � / ' Printed Name of Seller iqn Dat (MM/DD/vrrY) Printed Name of Seller a (MM, D/rrrh F.BUYER(S)/GRANTEE(S)'=APPLICATION FOR PROPERTY TAX DEDUCTIONS--IDENTIFY°ALL ITEMS H JR „' ', 1 z ❑ 1.Will this property be the buyer's primary 4 0 ❑ 3.Homestea residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 310 South West Mill Street III ❑✓ 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Patoka, IN 47666 Gibson ❑ Z 7.Geothermal Energy Heating/Cooling Device • City,State ZIP Code County 0 ❑ 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 ❑ 0 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. 2670 W 50 S Not available in all counties.) Address(Number and Street) �/ Princeton, IN 47670 Gibson �P —d y_ .25- /0.3 - 000. / ?d -0,L0 City,State ZIP Code County Primary property owner contact name E-mail