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P7
INDIANA SALES DISCLOSURE FORM
SDF ID
SDO ID 462827
Pagi 2
L511
F7PREPARER--s,
Leaann Grady Closer
1Preparer ofthe Sales Disclosure Form Title
7202 N Shadeland Ave Hocker and Associates
Addrests(NumberandStreet) Company
Indianapolis, IN 46250-
oV, State and ZIP Code Telephone ?lumber E oil
!E:_ SELLER (Sy/ GRANTOR (S)1-'T*R
The Secretary Of Hud
Suite, I - No., as appears an weveyent, d..,,,
Seller 2 - Name as appears an conveyance document
40 Marietta Street
Address (Number and Street)
Addness (Number amlsourt)
Atlanta, GA 30303-
City, State, and ZIP Code
ciry, Stow, and ZIP Code
E-mail
Telenhome.vamber E -mail
Underpenlities fper * _y I h7i�by certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
S "V
Xequ 7-ed/ "Real
amfCompfive I' W ndA=r&MS0WMce with IC 6-1.1-5.5, Property Sales Disclosure Act".
kap"IferbD I
q /0 'Remeare ofseller
F. BUYER_, NT PPLR�NION FOR-POEIR"TY TAX DEDUCTIONS-:IDENTinALL
ITEMSTHAT APPLY
,lefery G Gray
Buyerl Name as appmrson ca ncedocuesent
Buyer2 - Name as appears on conveyance document
Add-, her _ad Street)
Address (Number andSerem)
Oakland City, IN 47660-
cry. State, and ZIP Code
Ciry, State, and ZIP Code
Telep hone Number E-mall
Telephone Number E -mail
THE SALES DISCLOSURE FORM MAY HE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION - I
Fx F-1 1. Will this property be the buyer's primary
[:X] ❑ 3. Homestead
residence? Provide complete address of primary'+��
4. Solar Energy Heating/Cooling System
Solar Energy I
residence, including county:
S. Wind Power Device
519 W MORTON STREET
6. Hydroelectric Power Device
Address (Number and Streer)
Oakland City, IN 47660 GIBSON
❑ FLI 7. Geothermal Energy Heating /Cooling Device
1:1 FLI 8. Is this property a residential rental property?
City, State ZIP code Comet,
❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? if yes, provide
❑ E] 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.)
-/�J -
Address ( Number and Strina)
City, Same ZIP Lode County I
Primary property cavaer contact name 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 IC 6-1.1-5.5, "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.)
��mgnatur, of VY-1 Signor afBuyer2/Spuuse
I
z
Al Name offluyer2l5pouse Sign Vote
—yumber Lost 5 dUeftsroflivyer2lSpouse Dover's -State- -Last 5 Digits of Social Security
LiceriselID10ther Number Number Licensel1f,10ther Number
L511