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Under penalties of perjury, I 6ereby certify that H�is Sales Disclosure, to the best of mylmowledge and belief, is trve, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, °Real Property Sales Disclosure Ad".
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Buyc1 � Name as appears om m�veyana dowmm[
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TRE SllES DfSdOS1JRE fORM MAY BE USFD TOAPPLY FOR mtTA1N DmUCf10N5 FOR THIS PRWQL7Y. IDQlTIFYAI,I.OF THOSE THAT MPLY.
�(�/ U 1. Will this property be the buyer's primary
� residence? Provide complete address of primary
resideuce, includin county:
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❑ � Does the buyer have a homestead in lndiana to be
vacated forthis residence? Ifyes, provide
complete address of residence being vacated,
including county:
Add�f (Numbnand SbeetJ
clry,5mt�9P[ode counry
� ❑ 3. Homestead
❑ ❑ 4. Solar Ene�gy Headng/Cooling System
❑ ❑ 5. Wind Power Device
❑ ❑ 6. Hydroelech-ic Power Device
❑ ❑ 7. Geothermal Energy Heating/Cooling Device
❑ ❑ 8. Is this property a residential rental property?
❑ ❑ 9. Would you ]ike to receive tax statements for this
property via e-mail? (Provide contac[ informatlon
6elow. Please see instrvc[ions for more informadon.
Not available in al( counties)
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Under penalties of perjury, t hereby certify tLat this Sales Disclosure, [o the bes[ of my Imowledge and belief, is trve, correct
and complete az required by law, and is prepared in accordance with IC 6-1.1-5.5, "Rea] Property Sales Disdosure Act". (Note:
Spouse information, SociaJ Security and Driver's Licease/Other numbers are not necessary if uo Homestead Deduction is
being filed.)
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