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t\DI?�ASALESDISCLOSURE FOR�I
Samantha Cutsinger
Vrryarer oJNe Sclo Oiultuvre Form
226 W. Broadway
Addrm (Num6er and5vre�)
Princeton, IN 47674
Ory, Sare, and Z/PCOde
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Thomas Jason James a/kla T. Jason James
Srller 1- Name osoppmrs on emrvryvMe dwvment
2605 W 1025 S
Addrtu (Number and SvntJ
Ft. Branch,IN 4764&
Under penalties of perjury, I hereby certlfy that this Sales Disclosure, to the best of my knowledge and belie(, is [rue, correct
and complete as required by law, and is pre ared in aaordance wi[h IC 6-1.1-5.5, "Real Property Sale iscl sure AcC. (7�
�ti)l,s.J. _)n_,..,is � 1,iiA�P rn JQ1"Y2PS t-I2Q ��.�(;U
SignaNreofSelle� TSignam af5elfer
�+/z%L,�o �-I I S��zoi o
TAX
Nathan M Beloat
Bu�rr 1- A'ame ns o
ACdres (Number and SveelJ
Haubstatlt, IN a7639-
THE SALES UISCLOSURE FOAA1 MAY BE USEO TO APPLY' FOR CERT0.IN OEDURIOYS fOP THIS PROPER7Y. IOENTIFI' dLL Oi THOSE THAT APPLY'.
YES NO CONDITION
Q ❑ 1. Will this property be the buyer's primary
residence? Provide mmplete address of primary
residence, including county:
2605 W 1025 S
AAdreu (NUmber and Stree[)
Ft. Branch, IN 47648 GIBSON
Ciry, Smte ZIP Code Caunry
❑�] 2. Does the buyer have a homestead in lndiana m be
vacated for this residence? If yes, provide
romplete address of residence 6eing vacated,
including county:
Addras (Kum6er andSUttt)
Ciry.SmteLPCade Counry
Qx ❑ 3. Homestead
� Q 4. So ar �ne�/Cooling System
� Q 5. Wind Power Device
❑ � 6. Hydroelecvic Power Device
❑ � 7. Geothermal Energy Heatino/Cooling Device
� Q 8. Is [his properb; a residential rental property?
� Q 9. 4Vould you like to receive tax statements (or this
property via e-mail? (Provide contoct informotion
below. P(ease see instructions for more information.
Not available in all counnes.)
a�- i�-���o -ooa.a� �a�
ronmroname
Under penalties o(perjury, I hereby cerUfy that Ihis Sales Disclosure, to the best of my knoµ�ledge and belief, is true, correct
and complete as requif�ed by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[". (Note:
Spouse infor!�p [ion Social Security an��� ver's License/O[her numbers a notp e�j�� � om�stead Deductlon is
beinefiled.l% � % _� il / ; �l / � �/ � /` -1