Homestead_Hayes (10)ISDI.\�'A SALF,S DI$CLOSURE FOHM SUF ID SDO ID 774634 Paoe?
D.PREPARER
Holly Perkins Closer
Prepure�o(theSulerOitdomreForm Ttle
7202 N. Shatleland Avenue Hocker & Associates
,1dCreu(,vumberand Sner�) Company
Indianapolis, IN <6250-
E. SELLER S GRANTOR S � � � � � � - � � �
The Secretary of HUD
Selltrl �Nameasappenrsanronu<wnaedocumsnt Sellr�2-A'ameasap�enrsmmnvrymadorument
40 Mafietta SVeet
Adaress (NUmber arM SvertJ Addrexs (NumLer and Slreet)
Atlanta, GA 30303-
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❑Cde -penal[ies o pe 'ury, 1 herebvi certify that this Sales Disdosure, to tlie best n(mq knowledge and helie(, is true, correct
�� mplete as re ui ed by law, and i9jS��d'ASfi0G1tA3H� with IC 6-11-5.5, "Real Proper[}• Sales Disclosure Act".
Agent for HUD
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F. RUYER S GRANTEE S- APPLICATION FOR PRQPERTYTA.0 DEDUCTIO�'S- IDENTIFI' ALL ITE�1S THATAPPLI'
Angela Hayes
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(Glendale Sireet
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Pnnce�on,IN 47670.
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E-�rtai! T^le^Ironr E�mail
TIIESALFSDISCLOSUREFOR?IAtA1'6EUSCDTOAPPLYFORCEIITAINOEDURIONSFOPT OPERTY.IDEYTIF1'ALLOFTH pATqPPLY.
1"FS XO CO\DITION I YES RO CO\DITION
x0 � 1. Will this proper[y be the buyer's primary I❑x ❑ 3. Homestead
residence? Provide mmple[e address of primary I 4. Solar Ener � ting/Cooling Syscem
residence, induding county:
115 E. GLENDALE STREET S. 4Vind Po�ver Device
AAd�css(.'.'umberand5trettJ ❑ Q 6. , ecvic Power Device
Pnnceron, IN a7670 GIBSON � � 7, Geothcrmal Energy Hcating/Cooling Device
un•. s�a«zrv r.00e eo���.y
�{� Z. Does the buyer have a homestead in Indiana to be � �$� Is this property a residential rental prnperry?
vacaced for [his residence? If yes, pro��ide ❑ 0 9. SNoidd you like to receive tax stacements for [his
comple[e address of residence being vacated, property via e-mail? (Provide contact in(ormation
including county: below. Please see instructions for more in(ormation.
�bt availnble in nll caunties.)
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CiN.Sm[eZIPCodr Counry
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Under penal[ies of perjurp, I hereby ceriify that [his Sales Disdosure, [o [he best of my knowledge and 6elief, is [rue, correct
and complete as required by la�v, and is prepared in aceordance with IC 64.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse in(ormation, Social Security auei river's License/Other numbers are not necessary if no Homestead Ueduction is
being fi ed"s)
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s Smte Lnst 5 Di;gits ojSocial5ecunry• Number Las! i di,9itr o�Buyer?/Spousr Driver's State Losr 5 Di,�iesn�5oe'iol5rcuriry
lirense/ID/OtherNumbzr NumGer License/!D/OtherlJum6er