Homestead_CareyI\DIA\A SALES DISCLOSURE FOR�I SDP ID 26-2009-7000326
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KIMBERLY A LEWIS BROADWAY TITLE, INC. OFFICE MANAGER
P. �rer ofthe Sa!u D'uclwure Form T�le
. 226 W BROADWAY BROADWAY TITLE, INC.
PRINCETON, IN 47670
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MIDORI A BIRCH
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539 5 COUNTRY LANE
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FRINCETON. IN 47670
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]nder penalties of perjury•, 1 hereb}• cer�ify thar this Sales Disclosure, to the best of mr kno�cledge and belief, is true. correct and
omplete as required b}• law, and is prepared in accordance ��ith IC 6-1.L5.5, "Real Propertp Sales Disclosure:�ct".
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ALEX M CAREY
AVE
PRINCETON, IN 47670
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FOR�1 DI.\l' BE USED TO APPLI' FOR CERT,U�
r I. \Vill this propeny be ihe buyer s primary residence? Pro�ide
address ofprimary rcsidence, includine counrv:
539 S COUNTRY L4NE
PRINCE70N, IN 47670 Gibson
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r 2. Does �ha buyer ha��e a homrsiead io be vacared for this meidencz? If
}rs, provide comple�e address of residznce ��acating, includin� counry:
AdAress (.tlumm m�JStrc�/1
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APPI.
301JOHNSONAVE
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PRINCETON, IN e7670
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liomestead
r 4. Solar Enerey HeatingiCooling
r 5. \1'ind Po�ver D�vice�
r 6. Hydroelectric Power De��ice
�'- 7. Geo�hertnal Energy Heatin��Cooline Device
r 8. Is this propem' a rcsidcntial ren[al propetty?
(— 9. \Vould you like to recie��e ta.r statemznts }or ihis proprm �•ia
omail? (Proride conracr inJormaiion br[om. Plrusr see (he
insfruGlim6 (or more infonnaliort :\'or avai(c61e m all roumies.j
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Under penal[les o( perjun'. I hereb)' certit�' [hat [his S:11e5 Ursclosure, to [be besf o� m)' knoNletlee ana nellet. Is [rue, correc[ ana complele as
required b�� law, and is prepared in accordance wi[h IC 6-I.1-5.5. "Real Propertr Sales Disclosure Act". (\ole: Spouse In(ormatiun, Social Security
und Drire� License/other numbers are nut necessan� i( no Ilomestead Deductia�'jis being filedJ
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