HomeMy WebLinkAboutHomestead_Couts (2)YDLMA SALES DISCLOSURE FORM
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Seller 2- Name as appears on ronveyvnre dacvmm[
Address (Number and
Ciry, Smte, and 9P CoCe
E-mail
Under penalties of periury, I hereby certify that [his Sales Disclosure, to the hest of my lrnowledge and 6elief, is true, wrred
a ptete s re uire b taw, and s prepared in accord ce �ti�[h IC 64.1-S.S, "Real Proper[y Sales Disclosure Act".
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Bvyer 2- Nome as appu�rs on wnve�ance docvmrnt
Address (Number ond Stra[)
Ciry, Sm:e, and Z1P Code
THE SALES OlSCLOSURE FOILN M1L1Y HE USED TO APPL}' FOR CERTAL\ DEDURIORS FOR THIS PROPERTY. IDE.YTIFY ALL OF THOSE THAT APPLY.
❑ 1. lNil] this p:opery be the buyer's primar�
residente? Provide complete address of primary
� -_ � resid�nqe�induding county:
Ciry,Sm,l�e{l/.�� Code ' Counry
❑ � 2. Does ihe buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including tounty:
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Smte71P lode
Counry
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�]J ❑ 3. Homestead
❑ �/ 4. Solar Ener� Heating/Cooling System
� � S. Wind Power Device
❑ � 6. Hydroelectric Power Device _
❑ 7. Geothermal Energy Heating/Cooling Device
❑ �� 8. Is this property a residential rental property?
❑ I.C% 9. �4'ould you like to receive tax statements for this
r� property via e-mail? (Provide tontad informatlon
- below. Please see instrucdons for more information.
Nat availa6le in all coundes.)
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Aimorypraperryownerrnnmctname E-mail
Under penalties of perjury, I hereby cer[ify that this Sales Disclosure, to the best of mylmowiedge and belief, is trve, correct
and complete as required hy law, and is prepared in accordance �vith IC 6-1.1-5.5, "Real Property Sales Disclosure AcC'. (NoTe:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Ho stead Dedu�j ❑ is
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