Homestead_MortonINDtANA SA7.FS DIS LO RE FORM SDF ID: Pa e 2
D.PREPARER
C�Ei.1E D. EMMONS ATroR+Je`I •
Prepaw o/Ne Sa/a� Dixlmvre Farm T[le .
3�0� N. C�k£v.l �e�JFa2 RokA S�.�ITE. IKO ��sTwoltTriy �A+�A T�T�.C-, Co. �n1G.
ddras (Number and Stree[) Compony
EJknKJ�l,t.E �n! �I-�1i S
Ciry,SmrgandLPlode . TelephoneNUmber E-mail
E. SELLER S GRANTOR S
rlo�� I CM-D�¢or.�E
.Srlier 1- Name as appears om m�veyanre document Seller 2- Name as appears on cmveyonce document
l0$W'� (�JICa C.HAIi{{'1f1Nf\ Q.OkC
Addras(NumberandStree[J Addr�(Numberand5veet)
EJhNSJ�t,�.E � i�1 N't'(ZO
E-moil Tele honeNumber E�mail
Under penal[ies of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, cortect
and compl_ e as require�d is prepared in accordance with IC 641-5.5, "Real Property Sales Disclosure Act".
�
5{gnamreof /er SjgnamreofSeller
�i-1oL l�vt�-u6_.�o �—(a-- ci l C�
Pnn[edNameo S" nDate HN D PnnredNomea Seller 5' nDate(MH D
R S GRAnTEE S-A CATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY �
�06.M.1 R . M02TOn�
]-Nameosapyeorsanconv ment Buyer2-Nameasappearsanronveyancedo�vment
48 �,J c�2 23o uJ
Addrm (A'umber and Stree[) AdAras (Number and SbeetJ
P2�NGE��CO�•1 lwl �l'tle'l0
�
ry, Smte, and7JPCode Ciry, Srure, ond7JPCode
`
E-mail Tele haneNumber E-mail
THESALFSDISCLONREF02NMAYBEUSEDTOAPPLYFORCERTAIYOEDUCTIONSFORTHISPROPER DENTIFYALLOFTNOSETNATAPPLY.
YFS RO CO.�'DRIOA YFS RO CO.�'DITIO\
� 1. Will this proper[y be the buyer's primary [� � 3. Homestead
residence? Provide complete address of primary , o ar nergy Hea[ing/Cooling System
residence, including county: � � 5. Wind Power Device
KS �J crt 230 �J
Addr�(Numberand5vee[) ❑ � 6. Hydroelectric Power Device
PQW GE.T0�1 � n1 �ll b"1 O CytBSor1 � �' 7. Geothermal Energy Heating/Cooling Device
liry, Smre ZIPCade Gounry
� � 2. Does the buyer have a homestead in Indiana to be � �$• �s this property a residential rental property?
vacated for this residence? If yes, provide ❑ � 9• �/'�ould you like to receive tax statementr for [his
complete address of residence being vacated, property via e-mail? (Provide contactinformation
including county: 6e/ow. Please see instruciionsfor more informadon.
Nota/vaila6le in all counties.)� / n
Addr�(Numberand5tree[) /// // //[����• �[f�?_ oa /
V/�O 7 � oJ
liry, SmteZlPCade Counry
Primaryproperryownerronmctname E�mail
Under penalties of perjury, l hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is hve, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ad". (Note:
Spouse informa[ion, Social Security and Drivers License/Other numbers are no[ necessary if no Homestead Deduction is
being f�led.)� /�
'� /
5' reo/Buyerl n �y �� 5(qnamrea/BUyer2/Syouse
�LOaan /C /,/.✓�..� �'(Z�Z���
inredLeg Nameo(Buyer] 5{qnDate(HM/o0/vrvY7 Pdnredl.egalNameofBuyer2/Spouse S1ynDate(HH/00/YYYI)
�
LastSdigiGSO%Buyer2/SpouseDriver's State Las[SDigiGSO�SotialSecuriry
Liceue/ID/OtherNum6er Num6er Licente/ID/OtherNum6er