Homestead_BrewsterI�'DIANA SALES DISCLOSURF. FORJI
Samantha Cutsinger
� %eyarero/the5clesDucfarvreFOrm
226 W. Broadway
Addros /Num6er arM SureQ
Princeton, IN 47674
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SDF
SDOID 723374
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Page 2
Broadway Title, Inc.
Company
E. SELLER S GRANTOR S
Jawtyn M Frencti
&Ifer 1� h'ame us nppeum on mmnnn�e Jxummt Srller Z� Nome as upyevrs om m�vryonie duoument
7421 S Sunrise Dr.
qddrcrs (Nunber and Snn!) ACdrta (Numbrr anC Svar[)
FL Brench, IN 4764&
Ciq�. Sm[e andZlPCada oa, sroa. ��n zir caa:
Te/r hmeNumbrr E-mail
Under penalties o(perjury, I hereby certify that this Sales Disclosure, to the best o(my knowledge and belief, is true, correct
and complete as required by�aw, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disdosure AcC.
Signamrtaf5efler
F. BUYER S GRANTEE S-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFYALL ITEMS THATAPPLY
Banks M Brevrster Mary Ellen Brewsier
Buyer I� A'ame ns appanrs nn ronveyance davmen: Buyer: � A'eme as nFP�rs on conveyonre documen�
302 E. locusl St. 302 E. Locust Si.
dCdrers (Rumtirr mdStreeQ AdCr¢s (Number and StrerQ
FL Branch,IN a7648- FL Branch,IN 4764&
Ciry. Smre, and'CIP CoAe
N�A
TNE SALFS DISCLOSURE FON.N MAY BE USED TO APPLV FOR CERTAI.Y DEDURIONS fOR THIS PROPERTY. IDE.YTIF1',1LL OF THOSE THAT APPLI'.
XQ � 1. Will Ihis property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
7421 S SUNRISE DR.
A�Aren (NUm6er and Scrmt)
Ft. Branch,IN 47648 GIBSON
Ciry. Sm's ZIPCOCe Counry
��] 2. Does [he buyer have a homestead in Indiana co be
vacated for this residence? If yes, provide
romplete address of residence being vacated,
including munty:
dddrrts (Abmbzr andSvcrt)
Ciry, Smte ZfPCode
Counry
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3. Homestead
4. Solar Hnergy 1leating/Cooling System
5. Wind Power Device
6. Hydroelectric Po�+•er Device
7. Geothermal Energy Hea[ing/Cooling Device
8. Is this property a residential rental property?
9. 4VOUld you like to receive tax statements for this
property via e-maiR (Provide conmc[ informotion
below. Please see instrucoons for mare in�ormotion.
M1bt ovailable in a71 counties.)
-�R -�o a
Under penalties of perjury, 1 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 Uisclosure Act". (Note:
Spouse information, Social Ser�rity and Driver's License/Other numbers are not necessary if no Homestead Deducdon is
Pnnled Legal NamP vfBu)'¢r 1 Sign Eate (H.M/OD/nlYl
Las[idigi[so�BuyerlDriver's State LastSDigivo(SxiolSemnryNum6er
License/ID/O[her Num6er
5,9�� �,r«z�5v u r I
LostidigiaofBvyer2/SpouseDnver's Ste[e Las<SDigitso(SonclSecunty
Number License/lD/OrherAumAe�
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