Homestead_Phillipsn PRFPARFR- >..._ _ ._�..-_ - -.• _ s. ...'
Title
FOURTH ST., STE 500
City, Smte,an L Telephone
E:
Sellerl- ,Yameasapy�°rson conve}nncedacuamau / Seller2 Nameasapp
J6 S . (_i OSS SF
Ad ress (Numberand Street)
Address (Number and
Jpj, /,,,(
M`
Email
I al
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and2omplete as required by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
/07 -dl— llyl- I Signature oJSeller
on
Address (Number and Street)
6htF0*1D C TY q7 &26
❑ 1. Will this property be the buyer's primary
residence? Provide complete address of p ima
residence, in cl ding c unty: - F-1 101 S.
A m.(Number and Street) ❑
Ciry, St. mZ Code Counry El
vacated Does the buyer have a homestead in Indiana to be El
for this residence? If yes, provide
complete address 6f residence being vacated,
including county:
OF THOSE THAT APPLY.
❑ 3. Homestead
System
S. Wind Power Device
6. Hydroelectric Power Device
i.' 7. Geothermal Energy Heating /Cooling Device
[� S. is this property a residential rental property?
9. Would you like to receive tax statements for this
property via e-mail? (Provide contact information
below. Please see instructions for more information.
Not available in all counties.)
Address (Number and Street)
Ciry,Stam ZIPCade - County
Primary property owner concoct name E -mail