Homestead_MitchellSALES DISCLOSUREFORM SDFID:
Prtporer�����ic�igan gireet, Ste 910
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�"���i�e�ffffi`�Indiana 46601
Ciry, Sm[e, ond2(P Code
17� Name1 as' o1pp-mrs- on nron�ve-yunce document
)L�{ t'K>�!, 7'N�
ss (Num6er ond Street)
(�1ry-bn `r-�'�y . C i O ln
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r'�`Meridian Title Corporation
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E mail
Under penalties of perjury, I hereby cerrify that this Sales Disclosure, [o the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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� � ��i�ie�n s"/'✓ `�7�p10
-rare,
THE SALES DISCLOSIIRE FORM MAY BE USED TO APPLY FON CERTAI.Y DEDUCfI0Y5 FOR TNIS
❑ 1. Will [his property be the buyer's primary
residence? Provide complete address of E
,� � res�dence, including county:
u y owce cir �aae Counry
❑��1i 2. Does the buyer have a homestead in [ndiana to be
vacated for chis residence? If yes, provide
complete address of residence being vaca[ed,
including county:
Mdress (Number and Street)
Ciry, Smte
Caunry
Signaare of5eller
Buyer Z- Name as appean on conveyance
Addrw [Numbu cnd So-eet)
Ciry, Smte, nnd ZIP Code
❑ 3. Homestead
THATAPPLY.
Heating/Cooling System
Device
6. Hydroelec[ric Power Device
U � 7. Geothermal Energy Hea[ing/Cooling Device
❑ � 9. Is this property a residentlal renwl property?
❑ 9. Would you like [o receive tax statemen[s for this
property via e-mail? (Provide con[oc[ information
below. Please see instrucdons for more information.
Not available in aIl coundes.)
i i i i� /i �� i �i �
name
E�moil
Under penalties of perjury, I hereby cer[ify that this Sales Disclosure, to the best of my knocvledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance �vith IC 6-1.1•5.5, "Real Property Sales Disclosure Act". (Note:
Spouse informa[ion, Social Security and DriveNs License/O[her numbers are not necessary if no Homestead Deductlon is
beiygfiled.J „ ._� -,/ .�
Sign Date
Signac�re ofBuyerl/Spavse
PnntedLegalNumeofBuyer2/Spouse SignDa:e(KM/DD/rn1)
Las[Sd(qicso/Buyer]Drive�s Sm`te Las[SD[qicsofSocial5ecuriryNum6er I LastSd{qiCSOfBuyer2/SpouseDriver's Stace LastSDigicso%SocialSecunry
License/!D/O[herNum6er Num6er License/ID/OtherNum6er