Homestead_Birch (5)IilD1ANASALESDISCLOSUREFORM SDFID SDOID 731264 ' Page?-
D.PREPARHR
Samantha Cuisinger
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226 W. Broadvray Broativray Tiile. Inc.
AJdrm(NumLerorMSbertJ Campony
Princeton, IN 47670.
E. SELLER S GiL1NTOR S
Bryan Cromer
Sri/er 1� Name ox appeon on mmewme Jrcument Sellerl � Nume az uppevrs om m�vnvn�e dxumeV
12909 Mariison Ci. �
,iddreu(NumberandSaetQ Address(NUmberanES'vret)
Evansville, IN 47725
Tele honeNumbo E�moil
Under penalties o(perjury, 1 hereby certify that this Sales Disclosure, to the 6es[ o(my knowledge and belief, is true, correc[
and comple[e as required by law, and is prepared in aceordance with IC 6-1.1-5.5. "Real Property Sales Disclosure Act".
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Signamre af5eller Signa2rc ofSHler
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YERS G EES -APPLICATIONFORPROPERTYTAXDE IONS-IDENTIFYALLITEMSTHATAPPLY
Mark S Birch Carol Sue Birch
Buyrri-A'amens ursanronveyanwJorvmm¢ ��NO � Y mrsamm�vrynn[eCxummt
Iyland CL 72121 Wayland Ct.
dddress(Numbr�and5uee�/ AJdros(Numbrrand5trxt)
Evansville, IN 47725 Evansville, IN 47725
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iele honeNUm6er E-mail Tde haneNumber F-moil
THESALESDISCLOSUREFOftMMAYBEU5EDT0APPLYFORCERTAiNOEDUR10N5FORTHiSPROPERTV.IDE 'ALLOFTHOSETHATAPPLY.
YFS NO CONDITION NO LO DITIDN
� j� 1. Will chis properry be che buyer's primary ��� 3. Homes
residence? Provide compiete address of primary 4. Solar Gnergy Heating/Cooling System
residence, including counp�: � �
3284 W 50 S 5.4Vind Power Device
AAdreslNumberand5tr¢�) ❑ Q 6. Hydroelectric Po�ver Device
Princeton� IN 47670 GibSOR � � 7.GeothermalF.nergyHeaCing/CoolingDevice
Cip�, Sm[e ZIP Code Counn
�,� 2. Does the buyer have a homestead in Indiana m be � 0 g� Is this property a residen[ial rental property?
vacated for this residence? liyes, provide ❑ Q 9. 4Vould you like to receive tax statemen[s for this
comple[e address of residence being vacated, property via e-mail? (Provide contact in%rmation
indudingcount : below.Pleaseseeinstructions%rmorein%rmation.
�'� �2 ��Alg[/ Lf%U � iii Abt availoble in all counties.)
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Ciry, Smte LIPCode Counry
FTimvrypmperry owner mnmvt name E�mail
Under penalties o(perjury, I hereby certify that this Sales Disclosure, [o [he best o(my knowledge and belief, is true, correct
and wmplete as required by IaN�, and is prepared in accordance with IC 64.1-S.S, "Real Property Sales Disclosure Ac[". (Note:
Spouse informa[ion, Social Security and D�iver's License/Other numbers are no[ necessary if no Homestead Deduction is
beingfiled.) n ^ . „
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