Homestead_SchleterPreparer of the Sales Disclosure Form
�S Main St
ess(NumberandStree[)
Princeton. IN 47670 �
City, Smte, and Z!P Code
SeHer 7- Name os appears an ronveyance documen[
2?R9 Warrenton Rd
Address (Number and StreetJ
Haubstadt IN 47648
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Under p nalties of pe 'u , I hereby ce ify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and com lete ag r�-�y law/,gn�prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[".
of5eller
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Bvyer ]� Name asappe�Y6n conveyanre dotumen[
StrectJ
ROPERTY. IDENTIFY ALL (
� ✓Q 1. Will this property be the buyer's primary
residence? Provide complete address of F
residence, including county:
Address (Number ond Street)
lity, Smte Z/P lode County
� ✓� 2. Does the buyer have a homestead in Indiana to be
' vacated for this residence? If yes, provide
complete address of residence being vacated,
induding county:
Addres (M1'umber and StreerJ
Ciry, 5[ate ZIP Code Counry
YFS NO CONDITION
aacument
APPLY.
U L 3. Homestead
. � ,/ 4 nergy Heating/Cooling System
� Q 5. Wind Power Device
� Q✓ 6. Hydroelectric Power Device
❑ Q✓ 7. Geothermal Energy Heating/Cooling Device
� Q✓ 8. Is this property a residential rental property?
� �✓ 9. Would you like to receive tax statemenu for this
property via e-mail? (Provide contoct in%rmotion
6elow. Please see instrucaons for more information.
Not availa6le in all counties.
o?G - a3 -�� - o?QO - oQa.�-da 5`
ronmctname
E-mail
Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[". (Note:
Spouse informatio , S cial Security and Driver's License/Other numbers are no[ necessary if no Homestead Deduction is
bein� ' �/
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