Homestead_Shipman (3)I�'Di�1NA SALES DISCLOSURE FORPt SDF ID: Pa e 2
' D.PREPARER
Ushma Patiani
Reparer o/the Sales Diulosure Form Title
�7560 NW 74ih Ave
Address(Numberand5veet) Compauv
Parkland FL 33067
Cin�, Smte, and ZIPCOde Te/ephone,Yumber E-mail
E. SELLER S GRANTOR S
WIPER CORPORATION
Seller 1� Name as appears om m�veyantt dotument Se//er 1- A'ome as opptan on com�eyanre dacvment
_ 17962 Foztwrough L ane
Addres(Nmn6erand5vee[) qddress(Numbe�and5uret)
Boca Raton.Ff 33496
Liry. Smte. and ZIP Code Ciry, Srnte, ondZlP Code
E-mail TelenhaneNurnber E�mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, m the best of my knowiedge and belief, is true, correct
�nd comple[e as required bp la:v, and is prepared in accordante wi[h IC 6-1.1-S.S, "Real Property Sales Disclosure Ac[".
�J�--(� �--
Signaorzeo/ 1ler Signamreo/Seller
i,�J� cG�Q�n P.� 3. �.�o
Rinredh'mneof5eller L-1� 9cyt SIO�Dale1N11/OD/IYYI PnnredNOmeof5el/er
SianDare .v.v/OD/Y1'ril
GRANTE PPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
I JOHN W. SHIPMAN
Burer � ppearsonronveyanredxument Bvyer?-A'orneusoppeorsonronveyancedxument
720 S. Hart Street
Addras (A'umber or.AStreetJ Addr¢n (NUmbr� and Street)
Princetoa IN 57670 I
'FORCERTAINDEDOCf10\SFORTHISPROPER I�F. LOFTNOSETHATdPPLY.
1'FS RO C05OITIOY I 5'FS NO LOSDRIOY
G ❑ 1. 41+i11 this property be the buyer's primary 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heatlng/Cooling Sys[em
residence, including county:
� �✓ 5. bVind Power Device
AAdress(NumberandSneeQ � Q✓ 6. Hydroelectric Power Device
%O� SS�� rS't• �R �N� C�.v G�tf"�� � � 7. Geothermal Energy HeaUng/Cooling Device
Lint Smte ZlPCode LounN
❑ ❑ 2. Does [he buyer have a hnmestead in Indiana to be � ❑� �� �s [his property a residential rental prope: ty?
vaca[ed for [his residence? II yes, provide ❑ ❑✓ 9. N'ould you like ro receive tax statements for [his
complete address of residence being vacated, property via e-mail? (Provide conmct in/'ormation
including counry: below. Please see instructions/'or mare information.
Not availa6le in all counties.)
Address (h'mnber and Street) ^� _ /� � ^ � � ���' /O� _ D��
(/1 /
Cint Smte ZIP Cade [ounry
Pdmary properry mmer ronmc[ name E�moil
Under penalties of perjury, I�hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, torrect
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Securitv and Driver's License/Other numbers are no[ necessary if no Homestead Deduction is
being fi ed.) ��
�
J��v njBwrrl � �~ .SigncmreofBvyerl/Spuuse
,;� w �i, : p�, ��✓
Prin[
umber LasCSdigiCSOfBuyerZ/SpouseDriver's Smte LastSDigi6a%SotialSeturiry
License/lD/OtherNum6er 6�um6er License/lD/O[herNum6er