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Homestead_Smith (44)
INDIANA SALES DISCLOSURE FORM SDF ID: Pa_e 2 i p PRE AU,WW- _.%D _ _a i ...._, �_. .3 K3 , 4 . ik i- -i_g_ .; . __2_.._$ ._._ ; A ", ._.._ ts.._ `.w e ` Britany Bradshaw Agent Preparer of the Sales Disclosure Form Title 226 W Broadway Broadway Title, Inc Address(Number and Street) Company Princeton, IN 47670 mail i:.EI LL'ER S GRANTQR S . < ,:i .... I F 5 O M - Z }< M s i .._. .. .�:: ."$ ...�. .. ..,.: ..E�-,��'X'"-:'�,r`,a.-.-. ::-.o,.>�� K .rs,:...,,,ry .._, v,.::._... .sr..lw�.'� �1 .., ' -1 _ i.M_-,..TSSMS1 Kenneth Goldbach Robin A Goldbach Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 179 Lake Inwood Dr 179 Lake Inwood Dr Address(Number and Street) Address(Number and Street) Princeton, IN 47670 Princeton, IN 47670 City,State,and ZIP Code ity,State,and ZIP Code and belief,is true,correct and complete as rregquui d by law,and is prepared in accordance with IC 6- 1-5.5,"Real Pr per Sales Disclosure Act". Sir nature of Seller Signature ofSeller Kenneth Goldbach /Z`2o0O Robin A Goldbach ., 2-0 Printed Name a Seller Si'a Date MM DD/YYYY) Printed Name o Seller Si,n Date(MM DD T .. _.,ciz, EE S. .1 PP1ICAT-ION F0 2{PROPRRTXT.AXDtDUC-.T10NS_ JD T1Pi. AL -' 'EMS 'HATAPPLax . .' . IAntonio E.Smith Leiya Watanabe ! . spears on conveyance document Buyer 2-Name as appears on conveyance document 220 Ardmore Dr 220 Ardmore Dr Address(Number and Street) Address(Number and Street) Ferndale, Michigan 48220 Ferndale, Michigan,48220 E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPER I ENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION , YES NO CONDITION ❑✓ ❑ 1.Will this property be the buyer's primary , ❑✓ ❑ 3.Homestead GIBSON COUNTY AUDITOR CB residence? Provide complete address of primary ❑ is A. -. . : ergy Heating/Cooling System residence,including county: ❑ 5.Wind Power Device 179 Lake Inwood Dr Address(Number and Street) ❑ ❑✓ 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ ❑ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ ❑✓ 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 ❑ ❑✓ 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: '• = •. ' -, - - - - 'ons for more information. Not available in all counties.) Address(Number and Street) 1 26-12-06-201-001. 938-027 City,State ZIP Code County 1 u_'1'_Ti_____iii ..iuSliiii .•.__:.::.•_ E-mail