HomeMy WebLinkAboutHomestead_Vanoven (5)SALES DISCLOSUREFORM SDFID:
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Preparer of lhe Salc Disclasvre Farm
Indianaoolis. IN 46250
Ciry, Smte, and Z/P Code
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Faderal Natinnal Mort�w Assneiation
Seller 1� Kame as appmrs om m�veyvnn docvmm[
14?91 Ilallas Parkwap, Suife 1000
Address (A'umb<r a nd Svee[J
Ciry, Sru[e, aed Z!P [ode
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Customer Service Reo.
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Statewide Title Comoanv. Inc.
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Shcer d� Nome as appears on mmeynntt dotummt
Addres (A'vmber and Svrec)
Ciry, Smle, and ZIPCode
E mail
of perjury, 1 hereby certify [hat [his Sales Disdosure, to the bes[ of my knowledge and belief, is true, correct
an�.eop�ple[e as re,quired by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN UEDURIONS FOR
�❑ 1. Will this property be the buyer's primary
residence? Provide complete address oFprimary
, _ , residence, includjpQ counyq:
f/�i� ��efv� ..��� y�� �o C��,rs-�
Ciq•. Stace ZIP Code Counry
�� 2. Does the buyer have a homestead in Indiana to be
vacated for this residen�e? If yes, provide
wmplete address of residence being vacated,
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Ciry, Srare ZIP lode Covnry
Signamre of5elfer
By�er 2- Name asappmrs m mmq�ona docummt
Address (NUm6er and Sbeetf
Ciry. Smh, and ZIP Code
TNAT APPLY.
� 3.
Ener Heating/Cooling Sys[em
� � 5. Wind Power Device
❑ 6. Hydroelectric Power Device
❑ 7. Geoihermal Energy Heating/Cooling Device
� � Is this properry a residentlal rental propercy?
� �9. Would you like to receive Wx statements for [his
property via e-mail? (Provide con[act informotion
below. Please see instructions(or more in(ormation.
Not available in all counties.J
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PdmaryOroO�rt' ow'�«mnmtt nome E-mail
Under penaltles of perjury, 1 hereby certify tha[ this Sales Disdosure, [o [he bes[ of my knowledge and 6elief, 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 Act". (Note:
Spouse informa[ion, Social Security and Driver's License/Other numbers are no[ necessary if no Homestead Deducdon is
being f�ed.) ^ / / I
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Las[ 5 digiGS o(Bu}'er I Driver's Sm[e Lasf 5 �igiGS ofSariol Security Num6er
Litense//D/Other Number
Signaovr o(Bvyerl/Spouse
Pnued Legol A'vme of Bvyrr I/Spouse
Sign Da:e (.4.4/DD/rm7
LastSdigiGSO/Buyer2/SpauseDriver's 5[afe Last50igitsofSociolSecunry
Num6er Lirense/lD/OtherNum6er