Homestead_McGregor (3)I
INDIANA SALES DISCLOSURE FORM snF In- A d
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D.PREPARER -
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Prepare, of the Sales Disclosure Form a
Title
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Address (Number and Street)
E. SELLERS GRANTOR (S)
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Seller l - Nam as appears on conveyance document
Seller l- Name as appears on conveyance document
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Address (Number and Street)
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Address (Number and Street)
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Tele hone Number E -mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with 1C 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
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Printed o Seller Sian Dore (mg6RATM Sian Date IMMIDDIrrM
F. ER S GRANTEE S - APPLICAMN FOR PROPERTY TAX DE CTiONS= IDENTIFY ALL ITEMS THAT AP Y
r Bayer I- Naraeasappmrson conveyan=domment Buyer2 =Name as app ears on conv ance docum t
ey
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Ad ress ' Address(NumberandStreet)
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OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ 1. Will this property be the buyer's primary
❑ 3. Homestead
s residence? Provide complete address of prI ry
❑ N 4. Solar Ener g /Cooling System
residence, including county:
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Ind Power Device
❑ 6. Hydroelectric Power Device
Addresr(NumberandStreet)
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E) 7, Geothermal Energy Heating /CoolingDevice
CCity, State ZIP Code
County
10 g• is this
❑ 2. Does the buyer have a homestead in Indiana to be
property a residential rental property?
vacated for this residence? If yes, provide
❑ 9. Would you like to receive tax statements for this
complete address of residence being vacated,
property via e-mail? (Provide contact information
including county:
below. Please see instructions for more information.
Not available in all counties.)
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Address (Number and Street)
City, State ZIP Code County
Primary property owner contact name E -mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6- 1.1 -5.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
being filed.)
Slgnaatreof(Nyer] Signature ofBUyer2/Spa e �1
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