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DISCLOSUREFORM SDFID:
Preparrr oJ[he Sa/es Discbmre Form
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Address (Number and SvttQ
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Seller 7- A'ame m a➢pears om m�(�veyance davment Seffer 1- Name as appmrs an ronvq'cntt docummt
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AdCress(.vum6e�ondSveeQ ^ ACdren(NumberandSveeQ
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Under penalties of perjury, I hereby certi(y [hat [his Sales Disclowre, to the bes[ of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in atcordance wi[h IC 6-1.1-5.5, "Real Property Sales Disdosure Ac[".
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ACdress (Num6er and Svee[/
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Signo[ure o/Shca
Buyer 2- h'ame as ap➢ears on com�ryance documen[
Address (Nvmber and
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Tf1E SALFS DISCLOSURE FOR CERT.�1� DEOURIONS FOR TNIS PFOPERTI'. IOENTIFS' ALL OF TNOSE THAT APPLY.
❑ 1.4Vill tl�is property be the buyer's primary
residence? Provide complete address of primary
residence, induding counry:
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� � 2. Does die buyer havea homestead to be vacated for
[his residence? If yes, provide complete address of
residence vacating, including counq^
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3. Homes[ead
4. Solar Ener� Heacing/Cooling System
5. Wind Power Device
6. Hydroelectric Po�ver Device
7. Geothermal Energy Hea[ing/Cooling De��ice
8. Is this property a residen[ial rental property?
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Under penalties of perjury, I hereby certify [hat this Sales Disdosure, [o the best o( my knowledge and belief, is true, correct
and complete as repuired by I'a� and is prepared in accordancl with IC 6-1.1-S.S, "Real Property Sales Disclosure Act".
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