Homestead_TitzerRM
Rav M. Drulev Attomev No. 4759-26
Preporera(the SafaDinlosure Form T[le
Address (Num6er and Stree[)
Law O�ce of Rav Drulev
Campony
Fort Branch. IN 47648
lity, Smte, and ZIPCode Telephone Number E-mail
Stller ]- Name as oppevrr on mmeynnce docvmen[
q�'i� S 100 E
Address (Numberond Street)
� �
�a[6ara L Gilas
Sd1er2 - Name as appmrs on conveyvnce document
101:i4 Newingtnn Drive
AAdras(NumberandSVeeQ �
Qrlando FL 32A36
Ciry.Smte, andZlPCode �
�
Under penalties of perjury, l hereby certify [hat [his Sales Disclosure, to the best of my 4
and com te s rey� ired by I and is prepared in accordance wi[h 6-1. -S.S; "Real
�� l-, %�— I kv _ 4 �� I� nr,�
ojsdler
Buyerl
Addras (Number ond StreetJ
Fort Branch.IN 47648
1
SjgnoNre
Buyer 2 � Name as
and belief, is [rue, correc[
hales Disclosure Act".
Fort Branch IN 47648
.�
Telanhnna NnmMr � F-mnil
MAY BE USED TO APPLY FOR CERTAI,Y DEDUCf10M15 FOR TI{�5 PROPER7'Y. IDENTIFY ALL OF THOSE THAT APPLY.
�✓ � 1. Will [his property be [he buyer's primary
residence? Provide complete address of F
residence, including county:
_9233 S 100 E
Address (Number and Svret)
_Fort Branch IN 47648 Gibson
Ciry, Stoce ZIPCode � County
� Q 2. Does the buyer have a homestead in indiana to be
vatated for this residence? Ifyes, provide
wmplete address of residence being vaca[ed,
including county:
Q � 3. Homestead
❑ ❑✓
❑ ❑�
❑ ❑✓
❑ ❑�
❑ ❑�
a Cnl F �ating/Cooling System
5. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Hea[ing/Cooling Device
8. Is [his proper[y a residential rental proper[y?
9. Would you like to receive tax statemenLS for [his
property via e-mail? (Provide contact in%rmation
belaw. Please see instructians for more informadon.
Not available in all counnes.)
Address (NUmber and Strrey ^1
�!o � 9- Z 9- 340 �/ 03 �:; 0�.5
Ciry, Smte LPCode Covory
Pnmarypmperryawnerconmctname E-moil
Under penalties of perjury, I hereby certify tha[ this Sales Disclosure, [o the best of my knowledge and belief, is true, correct
and complete as required by law, and is�prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Ac[". (Note:
Spouse information, Social Security a/n/d Driver's License/O[her numbers are no[ necessary if no Homestead Deduction is
beingfiled� _ i .� // r�1. :n i�. r�i
2/Spouse
�'%.�
Las[SdigicsojBuyer2/SpauseDriver's Stare
Liceue/ID/OtherNum6er Num6er Liceue/lD/OtherNumber
Security