HomeMy WebLinkAboutHomestead_BryantDISCLOSURE FO
osurc form
�22 W Broadway
Addrm (Num6er and Stree[)
Princeton, ZN 47670
Llry, Smh, and L➢Code
rue
Broadway Title, Inc.
c��ny
ela x_ Hume
Selle� l� Name m oyymrr m ronve}+once docvmmt Sellr 2� Nam<as ap{mn m mnveyvnce dxvmmt
3437 S 100 w 3437 S l0U w
Addies (NumberandSveetJ Addiezs (Numbc and Sbst)
Princeton, IN 47670 Prince�on IiV 47670
E�maJ
Under penalties of perjury, I hereby cer[ify that [his Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and com lete as required by law and is prepared in accordance with IC 6-1.1-S.S, °Real Pro erty S les Disclosure Ac[".
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Buyr� 1- Name ot appmrs on aonvryann
Clry,
TNE SAIES DISQOSURE iORM MAY BE USm TO APPLY FOR CERTAIN DmURIONS FOR
�� 1. Will [his property be [he buyer's primary
residence? Provide comple[e address of F
residence, including county:
Addivt (Numbc and StreetJ
Ciry.Smm LP Code �oun y
� [� 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
comple[e address of residence being vacated,
including county:
Addrat (Num6o and Street)
Ciry.SmteLPCOtle Caunry
Buycl - Nome w oppmn on
�� PrinceEon; Itd 47670
CIry.Smtq and LPCOde I .
TNAT APPLY.
3. Homes[ead
�
. eating/Cooling Sys[em
� � 5. Wind Power Device
� 6. Nydroelec[ric Power Device
❑ � 7. Geothermal Energy Heating/Cooling Devite
� � 6. Is this proper[y a residentlal rental property?
� � 9. Would you like [o receive tax statemen[s for this�
property via e-mail? (Provide contnct informodon
6elow. Piease see instructions for more informadon.
Not available in all caundes.)
a'�G-/��s 3�0- 4�?• /6d'�- �%
w:� .............�..r.,,w�.r..��mrr�ame E�mafl
Under penalties of perjury, l hereby certify that this Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with tC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Drivers icense/O[her numbers are not necessary if no Homestead Deduction is
beipQ filed.) „ /f „
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�pn'n W Legal Name o/BUyn 1 Agn Date (MM/o0/vrvh
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Licenu/ID/Orher Num 6er
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AgnamrtoJBVyc1/Spouse �.
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