Homestead_WellsINDIANA S�1LE5 DISCLOSURE FOILM SDF ID: Pase :
D.'PREPARER ' . _ ° . ' _
Jennv Snerrill Cus[omer Servic� Reo.
� Preper¢ro`:nt5al'sD'uclomr=^orm Tide
.4aGress (kumber and S�ee.)
S;ai=wide Ti!i= Comoanv. Inc.
ionnanv
Indiaraoolis. IN 40250
Ci[x Sm[�, and ZIPCOd_ 7rleohone Num6e: E-mail
=?deral Hnm> 1 nar, Mnrinano Gorn •qt��n
Sell^r i� lJOme as aoomrs on conwyartre comn_r.:
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ALdreu (Numtier cnd Sc-n_:f
SeOe: ?- Nam^ as appears on ronvwmce du:un.er.:
Acdress(tiumbe: and5�eet)
(:3�rnllmn TX 750t(1
Cin�, Sms, enC ZIPCoae Cia.Sm:c, and ZIP Code
E�mail � TeleenaneA'umber E-mail
Und pen Itles of perjurc, I hereby certifi• [hac [his Sales Disclosure, to the best of my knowledge and belief, is true, correct
a comp e as required by law, and is prepared in accordance �vith IC 6-1.1•"s.5, "Real Property Sales Disclosure AcY'.
Si, amreof5eller � �� � � SipnamreofSeller
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THE SALES OISCLOSURi FORAI AIdY BE OSED TO APPLI' FOR CHRTdI�' UEOUGTIONS FOR TH IS
� � L Will tnis orooercy oe the buye; ; orimam
residence? Pro��de comolece address o� orimarv
residence,ind dingcounn�:
Ic��2 �i �C C�� � Lin r= i��
�drers (flum�er -na Svc[)
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U � Does the buye; have a homestead in Indiana co be
� acated for this r>_sidenc<_? If yes, provid=_
comolete address oi residence beinp vacat=d,
including county:
Adcress (Number md SveetJ
Cia•. Smte ZIP loae Launn•
OF THOSE TNAT APPLC.
U 3. Homestead
° ra� Hea�no/Cooiing Sys[em
J � 5. ltiind Pow2r Device
❑ �6. Hydroelec[ric Powe: Device
❑ � Z GPotnermal Enera- Hea7n�/Cooling Device
❑ I� S. 15 ChiS DroD=� :l' �! esidentlal rental oropem�?
� �. Would you like to ;=czive tas s;acements ior this
proper[}� via e-mail' (Provide conCoct ittformation
beiow. PleQSe see insrrucaons for more injormction.
Not avrilable in all counties.)
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Under penalties of perjuc}', 1 hereby c=rrif}� that this Sales Disclosure, to .he best of m}� knowledge and belief, is true, correc[
and complete as required by la�r, and is prepared in accordance with IC 6-1.1-S.S, "Real Propertv Sales Disdosure Ad". [Note:
Spouse information, Social Securit}- and Driver's License/Other numbers are not necessan� if no Homestead Deduction is
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