HomeMy WebLinkAboutHomestead_Garred1\DIA\,�SpLES DISCLOSURE FOR�1 - SDFID SDOID 489666 �) Page2
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D.PREPARER
F(imberN A. Lewis Office Manager
, %eyarero/IhekfoUirdosureFOrm TiUe
226 W. Broadvray
AJdras(Nvm6ero+M SVer[)
Princetan, IN 47674
Ciry.Smle, andZ/PCade
Dennis l. Harpe
Srller 1- A'ome as appevn om m�veynnw davment
704 W. Ulen Si.
Addrrs (Num6er and Sorel)
Fort Branch, IN 4764&
Broadvrdy Title, Inc.
cam��y
Donna L. Harpe
Shcer2 - Nvme os upyevrs un <vnvrm�e doevmenl
104 W. Ulen St.
ACdrezs(NUm6erandSrmQ
Fort 8ranch, IN 4764&
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Under penalties of perjury, i hereby cer[ify that this Sales Disclosure, to the best o( my knowledge and belief, is tne, correct
and tomplete as required by law, and is prepared in accordance with C 641-5.5, "Real Property Sales Disclosure Act".
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nvwJ � ' � G,it�- � o( Xf�CGf�sz
aSignamrrof5elln Signa��rro(Selfer —�
��S �.. Nu ���r II -IO-�o�� !..bnJ.JA L. H/+R�E //-/o-�v�u
Gartetl
dwvmen:
Princeton, IN 47670.
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TNE SALFS DISCIASV RE FORM MAY BE USED TO APPLY FOR CERT,II.Y
❑x ❑ 1. Will this properry be che buyer's primary
residence? Provide complete address of E
residence, including county:
104 W. ULEN ST.
Mdnu (NUmber and5trxtJ
Fotl Branch.IN 47648
Ury.SmnZIPCaCe
NOT APPLICABLE
Counry
❑� 2. Does the buyer have a homestead in Indiana co be
vacated for this residence? If yes, provide
compleie address of residence being vacated,
including county:
Addras (A'um6er ar.d Svtti)
Ciry. SmteZIP Code Counry
EY ALL ITEMS��THAT APPIY
Buyer I� Nome as appearzon convewnre doNmen(
Addr� (Number and Svnt]
Ciry.
APPLV.
Q ❑ 3. Homestead
System
5. Wind Power Device
6. Hvdroelecvic Power Device
� Q 7. Geothermal Energy Heaung/Cooling Device
� Q 8. Is [his property a residential rental property?
❑ Q 9. Would you like [o receive tax statements for this
property via e-mail? (Provide contocc information
below. Please see instructlons(or more in%rmanon.
M1bt ovailable/iy/�all caunties.J
C/X!� �/���' /'�� �(..l..�i.�7v '^^�
NimvrvnmorrNO�mncanmvtname £-me1!
Under penaltles of perjury, 1 hereby certify tha[ [his Sales Disdosure, [o the best of my knoµ�ledge and belief, is true, correc[
and complete as required by Iaw, and is prepared in accordance with IC 641-5.5, "Real Property Sales Disdosure Ac[". (Note:
Spouse information, Social Security and Driver's License/O[her numbers are not necessary if no Homestead Deduction is
b�g filed.) � �
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