HomeMy WebLinkAboutHomestead_Wirth (4)� . INDIANA SALES
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Under penal4es of perjury, I hereby certify that this Sales Disdosure, to the best of my Imowledge and belief, is trve, correct
and co 1 te as requ'ved bKlaw, and is prepared in accordance with IC 6-1.1-5.5, °Real Property Sales Disclosure Ad".
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Buyer 2� Namem appmrs om m�vryancedoarmmt
Add�s (Num6n and StreR)
Clry, Smtt and7JPfnde
THE SAIFS DISdOSURE iORM MAY BE lISED TO MPLY FON Q'ATAfN DmULT10N5 iOR THIS PROPPRiY. fDFNfi}Y ALL Oi TNOSYTHAT APPLY.
�❑ L Will tlus propertybe the huyer's primary
residence? Provide complete address of primary
resid�ce, includin cp�nty:
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Ade�m(N�mboa Streety ' � �i^'^� � �VSII'
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City,Smte9PCade County
❑ � Z. Does [he buyer have a homestead in lndiana to be
vacated for this residence? Ifyes, provide
complete address of residence being vapted,
including county:
Addres (NumbvandStrer[)
Clry, State ZIYCade Counry
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3. Homestead ���
4. Solar Energi� Heating/Cooling System �R �
5. Wind Power Device ��
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is this property a residential renhal property?
9. Would you like to receive [ax statements for [his
property via e-mail? (Provide contact information
below. Please see instructions jor more informaaon.
Not avai ble in all coundes)
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Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is W e, corred
and complete as required by law, aad is prepared in accordance with IC 61.1-5.5, "Real Property Sales Disdosure AR". (Note:
Spouse information, Social Security and Driver's Licease/Other numbers are not neceuary if no Homestead Deduction is
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License//D/Otlier Number
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SYgn Dafe (MM/DD/YYY1)
SecurityNumber I LastSdigitrofBuyer2/SpouteDnver's SWte` LastSDjgifsof5ocialSecunry
Number License/ID/OtherNumber
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