Homestead_Hull DIANA SALES DISCLOSURE FORM FINir SDF ID: Page 2
11 _:_:,-._ LI-
Leon C. Stone President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title, Inc.
Address(Number and Street)
E-mail
:E.'SELLEft(S)16:FaNf ORO,` ,5' : , .--- :, -, :.'',1 I',,--',;;:-' i'':''•''' ' ^ - --.. ,7--' ' -7 -
Charles W Michel Amelia A. Michel
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10.247 W SR 165 10247 W SR 165
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 Owensville, IN 47665
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 requi d by)aw,and is a accordance with IC 6-1.1-5.5,"Real Property Sales Di losure Act".
Signature of Seller Signature of Seller
r,harles W Michel ,hs-A„,.., Amelia A. Michel &/c2oP/2_02-1)
Printed Name of Seller Sign Dat (MM/DD/YYYY) Printed Name of Seller Si.n Date(MM/DD/YYYY)
1130 NEW)/MI4tERM_ZARIR At i OR poknei ptim IT abm Arc to N4in s 1-TIR-A tufws Tar Apw
4 rant 57-Aiiii—\ 4-Cliristina L. Hull
Btiji-eFf7-1Chme as appears on conveyance document Buyer 2-Name as appears on conveys cecdocfent 1709 S.S. Main Street 1709 S. Main Street
Address(Number and Street) Address(Number and Street) 0-%
Princeton, IN 47670 Princeton, IN 47670 a tk I.
,
E-mail Telephone Number Ai A Ot.)
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT A 'GO\31.4'
c,OV1
YES NO CONDITION YES NO CONDITION
Z 0 1.Will this property be the buyer's primary L 17-37Homest-did-7).
residence? Provide complete address of primary El M 4.Solar Energy Heating/Cooling System
residence,including county:
0 z 5.Wind Power Device
10247 W SR 165
Address(Number and Street) 111 IZI 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson Ef IZI 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 0 8.Is this property a residential rental property?
z 0 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide El 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: below.Please see instructions for more information.
1709 S. Main Street Not available in all counties.)
Address(Number and Street)
Princeton, IN 47670 Gibson C-27/2"/7:17.1e0=-001,161-Dall
City,State ZIP Code County —— - -- -.y
Primary property owner contact name E-mail
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