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Homestead_Reyes (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Jeff Fox Title Coordinator Prepar•er•of the Sales Disclosure Form Title 3930 Mezzanine Drive.Suite C Columbia Title, Inc. Address(Number and Street) Sa SE L _ R ti . Amy R.Brouse Seller 1-Name asappe rsonconveyancedocument SellerS-Name as appears on conveyance doctnnent 3C 0 Vto Cncic* dress(Number and Street)t) � �� o**� Address(Number and Street) C; ttV U�. City,State,and ZIP Code City,State,and ZIP Code E-mail _ Telephone 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 an omplete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". (-- Al,f_37A, SignatuSeller Signature ofSeller Amy R-Brouse 11/10/2020 Printed Name o Seller _ _aa Sign Date(MM/DD/YIYY) !rifted Name of Seller Sign Date(MM/DD(YrVY) Win'�E [S)/CiItf�`I CS italfl r12,.#It 00—t4 X DE 5VAIONS ,JMNU IP 1 M1 I'1 ?�MM ._..N i, Juan Alberto Reyes F I LED Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1008 South Stormont Street Nov 10 2020 Address(Number and Street) Address(Number and Street) Princeton .IN 47670 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 APPLY. YES NO CONDITION YES NO CONDITION m ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 1008 South Stormont Street ❑ E 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Princeton,IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ i'��'r`/ 2,Does the buyer have a homestead in Indiana to be ❑ IZ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 117 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. Not available in all counties.) Address(Number and Street) . 26-12-18-202-000.142-028 City,State ZIP Code County Primary property owner contact name E-mail Number License/ID/Other Number