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Homestead_West (6)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Britanv Bradshaw Agent Preparer of the Sales Disclosure Form Title 226 W Broadway Broadway Title, Inc Address(Number and Street) Company Princeton, IN 47670 812-386-1687 Britany(a�Broadwav-Title.com City,State,and ZIP Code Telephone Number E-mail -E SELiER(S)/.GRANTQR(S)... Y n COw. ...MBk. ,._..? D_ ' - ._. ' _,a5,...._4_ y-.rv.ai-R v _. CP Patrick W Martin nehra Martin Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 2500 F Lake Rd 2500 F Lake Rd Address(Number and Street) Address(Number and Street) Princeton. IN 47670 Princeton- IN 47670 City.$tate,and ZIP Code City, a ZIP Code �� Z 1 ;- �(-CM _ -SSC l ' � f 7 Telephone Number E-mail Telephone Number E-mail • i • ' •nalties o I • ' ereliftertify that this Sales Disclosure,to the best of my knowled a and belief,is true,correct ' and co yr let• •44 law,a ' is prepared in accordance wi IC\6- -5.5," pertyS ales Disclosure Act'. ; NNI ___...:...„ 1)./ / . Signature o 10- ) h Signature of Seller Patrick W Martin~ 1 0 - a)-- ,: o43 Debra Martin /�°UL Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name ofSeller Sign Date( f MM/DD/YYYY) F i'JYER(S,)jGrRANT,EE(SreaPI;ICAT ON3FOR„PROPEaY TA _DEDU,CTIONSRM:MfRabtag MVITWOMMIZZATON Storm R West Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 500 W Wamock B16 Address(Number and Street) Address(Number and Street) FILED Princeton, IN 47670 City,State,and ZIP Code City,State,and ZIP Code (91g) 4077--„;---(2�7 Oct 222020 Telephone Number E-mail Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPL . YES NO CONDITION YES NO CONDITION GIBSON COUNTY AUDITOR CB IZ ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ ❑✓ 5.Wind Power Device 2500 Ad dress E Lake R Address(Number and Street) ❑ Q 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 2 8.Is this property a residential rental property? ❑ 1Z1 2.Does the buyer have a homestead in Indiana to be ❑ 9.Would you like to receive tax statements for this vacated for this residence? If yes,provide complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. Not available in all counties.) Address(Number and Street) 26-12-09-103-000.592-027 City,State ZIP Code County E-mail Primary property owner contact name 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 required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being d.) /. ../._________ • Sig tureofBu rl Signature of Buyer2/Spouse iO-fit -3 C Storm R egoW Date(MM/DD/YYYY) Printed Legal Name of Buyer 1 Si'n Date(MM/DD/YYY}� Printed Legal Name of Buyer 2/SpouseSign / �n Li-q 0 f C • \) 71J,�,qC Last5digits of Buyer I Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security License/ID/Other Number Number License/ID/Other Number N l