Homestead_SchaferINUTANA SALES DISCLOSURE
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Address �h'umbei and Snre�J
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E. SELLER($1 /G RA NTORlCI :�
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SDF ID:
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Under penal[ies of perjury, I hereby certify [hat this Sales Disdosure, to the best of my knowledge and belief, is true, correct
and cou�ple[e a�eq�ir8d�w, a� is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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Signamre
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S�gnamre o(Shco
Name
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TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FON CERTAIN DEDURIOYS FOR TNIS PROPEHTY. I�ENTIiY ALL OF TNOSE THAT APPLY.
❑ 1. Will Ihis property be the buyer's primary
residence? Provide complete address of primary
StreeQ
(.J
�ritr. rZIPCm/e . . . Counry
� 2. Does [he buyer have a homes[ead in Indiana [o be
vacated fm� [his residence? If yes, provide
complete address of residence being vacated,
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1l, I��.rt� IN y�S�1 i�iR�SZ._
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YFS NO CONDITIOY
❑ 3. Homestead
� � 4. Solar Energy Heating/Cooling System
❑ � S. Wind Power Device
❑ � 6. Hydroelec[ric Power Device
❑ � 7. Geo[hermal Energy Hearing/Cooling Device
❑ [� 8. Is this property a residential rental property?
❑ � 9. Would you like [o receive tax s[atements For [his
property via e-mail? (Provide contacf informafion
below. Please see instructions�or more in%rmation.
Abt availa6le in all counties.J
a�,_o,�-yd���/-a� i 9�6 oa�
Primaryproperryownermnructnvmr E-mvd
Under penalties of perjury, 1 hereby cer[ify [ha[ this Sales Disclosure, to the best of my knowledge and belief, is [rue, correc[
and comple[e as required by law, and is prepared in attordance wit IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse informa[ion, Social Security and Driver's License/Other nujn�ers are no[ nece�sar,y if no Nbmestead Dedut[ion is
being fil,ed.)n � _ I I � /1 /X I� .
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SotialSerunry
Number Lirense/ID/OffierNUmber