Homestead_Wagner (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Colleen D Dunn Closer
Preparer of the Saks Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Nwnber and Street)
7; -
,,-.:-,t,..,-
Mission Real Estate Group,Inc
Seller 1-Name as appears on conveyance document Seller!-Name as appears on conveyance document
?C' DI
Address(Number and Street) Address(Number and Street)
7- --•Pe--.1.."\ U(tIce ..---27 VI cie 766,5'
Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
(xe and co ete as r ,ji'ed ,r,--"gnd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
/Of----fr'
,Sfghature ofSeller Signature ofSeller
ames M. Chappell,President 0412-0/20Zo
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name ofSeller Sign Date(MM/DD/YYYY)
kisMit'A : t(si.41,APPLiatibtsrPOklikeinitrttAktiffnert(N§iltiENTIKVf'Attifitiii§tilkiTAIVEY=:;7,17,;-:.T2:-.,;.:::-.::_si.
Taylor B.Wagner
- n conveyance document Buyer 2-Name as appears on conveyance document
329 S 5th Street,Apt 40
Address(Number and Street.) Address(Number and Mreer)
FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THA -
YE 1 NO CONDITION 0 NO CONDITION GI SON rni INTv AUDITOR
0 1.Will this property be the buyer's primary 3.Homestead
residence? Provide complete address of primary 0 4.So ar Energy Heating/Cooling System
residence,including county:
0 5.Wind Power Device
217 E Emerson St
Address(Number and Street) 0 0 6.Hydroelectric Power Device
Princeton,IN 47670 Gibson 0 0 7.Geothermal Energy Heating/Cooling Device
cao,,,S ZIP Code trg) County El 8.Is this property a residential rental property?
0 2.Does the buyer have a homestead in Indi ana to be
0 0 9.Would you like td receive tax statements for this
vacated for this residence? If yes,provide
property via e-mail? Provide contact information
complete address of residence being vacated,
e ow.Please see instructions o information.
including county:
Not available in all counties.)
Z -‘2"Address(Number and Street)
for B.Wagner - ________
Number License/1D/Other Number