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Homestead_Krutz; �. ; �. INDIANASALFSDISCLOSUREFORPf SDFID SDOID 759036 Pvge 2 D: PREPARER' J .. - Samantha Culsinper Prtpare�oJNe Safe Oiuhwrt Po�m Ptlr 226 W. Broadvray Broadway Title, Inc. I Addrea(Num6e.and5trtet) �po�� Princeton,IN47670- E. .��4 .__ . . ..��e,.. .. . .. .. . . . . - . .!S: .c_ . ^ Michael H Sibbitt Seflrr 1� Nume or eppeurs m mnvryvnce Jorummt $¢fle� Z- Name os uppevrs m mnveyon�e docvmmc 6849 S 500 E Addrat (NnmberorW Suee[) Addres (Num6erandStrer[) FL Branrh, IN 4764& � Ory.Smrq and LPCade / -} Ciry, Smt4 and LP fnde Tele honeNUmber E-mc/i Under penaldes of perjury, l hereby cer[ify that [his Sales Distlosure, [o [he best of my knowledge and belief, is true, correc[ an��9mple�e a�reqNired �y�aw, at��l Is prepared In accordance with IC 64.1-5.5, "Real Property Sales Disclosure Act". Brian K Addrea (Numbrr and 5frertJ Ft. Brench, IN 4764& TNESALFS Signatur<o(Seller Rarhel E Krvtz tllrye�[�N atanS[arson[onveyvnttJO[ument 500 S. Center St. Addrev(HUmberand5[neQ Ft. Brandi, IN a7648- 9E USED TO APPLY FOR CERTAIN OEUUCTIONS FOfl THIS PROPERiV. IDENTIFY ALL OF THOSE TNAT APPLY. x0 ❑ 1. Will this property be [he buyer's primary `/, residence? Provide complete address of primar}'� residence, including county: 6849 S 500 E Bddreu (KUm6er eud Strnt) Ft. Branch, IN 47648 NOT APPLICABLE Clry, Smm ZIFCOdt Caunry QX ❑ 2. Does the buyer have a homes[ead in Indiana to bc vaca[ed for this residence? !f yes, provide [omplete address of residence heing vata[ed, intluding county: 500 S. CENTER ST. � Addreu (Numbe� aM So-eeQ Ft. Branrh, IN a7648 GIBSON [iry, 5mte 11PCade Covnry 3. Heating/Cooling System � Q 5. Wind Power Device � Q 6. Hydroelectric Power Device ❑ Q 7. Geothermal Energy Hearing/Cooling Device ❑ Q 8. Is [his proper[y a residential rental property? ❑ Q 9. Would you like [o receive tax statements for this property via e-mail? (Provide contact informotion below. Please see instruc[ions for more information. Not available in all counties.) dG /9-/3 -/ao - �oi o3G - oa.S _ RimaryproO�l'mvnmm�mctname &mafl Onder penalUes of perjury, I hereby cer[ify [hat this Sales Disclosure, to [he best of my knowledge and belief, is true, rorrect and comple[e as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note: Spouse informadon, Soclal Security and Driver's License/O[her nu ers are no[ necessary if no Homes[ead Deducdon is being filed.) _� . �_ 1 n � 1 . Lost 5 digiGS of Buyer I Dnver's Smre Last 5 DigiS o%Social Sxunry Num6er I Last 5 di License/ID/Other Number Number yerl/SpouseDrlveri Sm[e