Homestead_Scales INDIANA SALES DISCLOSURE FORM SDF ID: 13ge 2
Christina Latham Title Clerk
Preparer of the Sales Disclosure Form Title
4600 WASHINGTON AVE, SUITE 102 Regional Land Title
Address(Number and Street)
mail
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SCOTT L MASON JACKLYN S MASON
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
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,Iress(Numer and Street) Address(Number and Street)
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City,
E-mail Tele one Number E-mail
Un er pensIties of perjury,I hereby certify that this Sales Disclosure,to the best of my kilowledge and belief,is true,correct
anSI cojets r quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
viigh(ature bfSeller Signature of Seller
SCOTT L. MASON JACKLYN S. MASON
Printed Name offeller Sian Date(MM/DD/YYYD Printed Name o Seller .:S:ign Date V.11HZDD/YYYY)
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YARYFIlt$)IRAN TERSIt..APetaafi OX VT)IMO-TARTY ViktiEritieb115 8 WM'ALLI:ITM Wt:APPLY:,'
MELANIE R. SCALES
Buyer 1-Name as appe rs on conveyance document Buyer 2-Name as appears on conveyance ocum
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Address(Number and Street) Address(Number and Street)
MAR 1 La
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E-mail Telephone Number 0N E-mail
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY', r
• 4 LID/TOF?
YES NO CONDITION x....„..,
1:1 YES NO CONDITION
1.Will this property be the buyer's primary
Z 0 3.Homestead
residence? Provide complete address of primary 0 Z 4.Solar Energy Heating/Cooling System
residence,including county:
0 111 5.Wind Power Device
1116 CAROL AVENUE
Address(Number and Street) 0 [ZI 6.Hydroelectric Power Device
PRINCETON, IN 47670 GIBSON 0 Z 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
Aid 2.Does the buyer have a homestead in Indiana to be 0 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide El Z 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.
1 n3S'" .\---/reak r(-e___P r Not available in all cour4tzi s.)
Address(Number arul Street) -
- LI—v-1'2-S— Thomas E. Barrett,Jr.
City,State ZIP Code County
Primary property owner contact name E-mail
• Number License/ID/Other Number
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