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Seller 1� Namr as appeun pm m�vpynce duvmrnt
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Under penaltles that this Sales Disclosure, to the best of my knowledge and belief, is We, correct
and com te as requlred by law,`�epared In accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure AcC.
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[�❑ 1. Will this property be the buyer's primary
residence? Provide tomplete address of primary
residence, including county:
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❑� Does the buyer have a homestead in Indiana to be
vaca[ed forthis residence? Ifyes, provide
complete address of residence being vacated,
including county:
Address (NUmber and Svn[J
Ciry.Sm¢ Z1P Code Cavnry
Buyc1- Name asappears on rnnveyimce docummt
Addrw (NUmber nnd Strret]
and LP Ude
TNAT APPLY.
APPLY
� ❑ 3. Homestead ` '�
� ` � a.,..�� ooling Sys[em ^��
❑ ❑ 5. Wind Power Device S�
❑ ❑ 6. Hydroelectrit Power Device �0.
❑❑ 7. Geothermal Energy Heating/Cooling Device
❑❑ 8. Is this property a residential ren[al property?
❑❑ 9. Would you like to receive cax statemencz for this
property via e-mail? (Provide con[ac[ informatlon
below. Please see instrucdons jor more informadan.
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Under penaltles of perjury, l hereby certlfy that thls Sales Disclosure, to the best o( my knowledge and belief, is trve, correct
and complete as requlred by law, and Is prepared In accordance wlt6 IC 6-1.1-S.S, "Real Property Sales Dlsclosure Act". (Note:
Spouse Intormatlon, Social Securiry and Drivers Wcense/Otber numbers are not necessary If no Homestead Deductlon Is
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