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�INDIANA SALES DISCLOSURE
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Shcer I- Name as aypmrs on �onveyantt dacumen[ Seller I- Name as appears on aonveyanre docvment
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Under penalties of perjury, I hereby certify that [his Sales Disclosure, [o the best of my knowledge and belief, is [rue, correct
and complete as required by law, and is preRared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act".
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Slgnamre o(Seller
Bvye� 2- A'ame as oppevrs on rnm�eyanre docvmenl
Addras(Numberand5treet)
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIY DHDUCf10N5 FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
�❑ 1. Will [his property be the buyer's primary
residence? Provide complete address of primary
3 a? � re ide ce, in�cluding cgy j�_ty:
�ndres;,(Number ndp Stree[) I � � � � O ` � ,^
i' r � ✓iC� w r�• ° � -
Ciry.SrureTJPCode ' County
� � 2. Does the buyer have a homestead in Indiana to be
vaca[ed for this residence? If yes, provide
complete address of residence being vacated,
including county:
Address (A'vmber and Streft)
Ciry. Smre ZIP [ode Counry
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3. Homestead
4. Solar Energy Heating/Cooling System
5. Wind Power Device
6. Nydroelec[ric Power Device
7. Geo[hermal Energy Heating/Cooling Device
8. Is this property a residential ren�al property?
9. Would you like to receive tax statemencs for this
property via e-mail? (Provide contact informotion
belo�v. Please see insuvctions for more informa[ion.
Not available in all countiesJ
E-mail
Under penalties of perjury, l hereby certify that this Sales Disdosure, to the bes[ of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance �vith IC 6-11-5.5, "Real Property Sales Disclosure AR". (Note:
Spouse information,�5ocial Security and Drivers License/O[her numbers are not necessary if no Homes[ead Deduction is
5(gnaare of Buyer2/Spovse
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