HomeMy WebLinkAboutHomestead_Littlepage (3)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D.PREPARER - �- _. ,. _. .. . �
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USHMA PATTANI
Preparero(the5ola Oiulosure Form T�tle
7560 NW 74th AVE
Addras(NUmberandSVee[) Componv
PARKLAND.FL 33067
E-mail
E. SELLER S GRANTOR Sl ' - � - �� - � - � � ��
WIPER CORPORATION
Seller 1- Name as appears on mm'eyanre dxvment Sellrr2 - Name as appears on ronveyante da'ument
17962 FOXBOROUGH LANE
,�de.� �,v�me�, a�e saKq Address (NUm6er cnd Svce[J
BOCA RATON FL '::1496
Ciry.Smte. andZlP Code Ciry. Sw[e, andllPCode
E�rnail Tele honeNUm6er E-mail
Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, [o [he bes[ of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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Sig�JSeller/ Signaoireaf5eller
VWOn f7 r;l IPTA Pr s Wi��p 03/OSI20�2
PnntedNameolStller SianDatefMH/DD/YYYTI PnntedNameaf5eller SIan0014 MM/DOM»1
F. BUYER S GRANTEE S= APPLICATION FOR PROPERTT TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APP6Y
THOMAS LITTLEPAGE
Buvrr 1� A'ame as appears m mnvevanre documen[ Buve� 2- Name as appears om m�veyanre da'ument
172 E 3rd STREET
AJdress(Numberond5veet) Addrxs(Num6erandSVee[f
HAZELTON. IN 47640
TelenhoneA'umber E�mail itfeohoneNUm6er E-mail
TNE SALES DISCLOSURE FORM AIdY BE OSEU TO APPL\' FOR CERTA W DEOOCf IORS FOR T411S PROPERTY. IDEhTIFI' A6L OF TMOSE THAT APPL1'.
5' NO CORDITIOp' I 1'FS RO CONDITIO\
� 1. N'ill [his property be the buyer's primary '� 3. Homestead
residence' Provide complete address of primary L Q 4. Solar Energy Heating/Cooling Sys[em
reside includin� county:
// �1 � 3/�� S T° ❑ ❑✓ S. Wind Power Device
� ���� ❑ Q 6. HydroelecMc Power Device
�.4Q° ress Num6erand5treet) �/
" a- 2. �%�o n 1'� '7 % �``� ��SO�% ❑ 0✓ 7. Geo[hermal Ener� Heatlng/Cooling Device
Ciry.Smte ZIPCade Lovnn
� �t[-�p� 2. Does the buyer have a homes[ead in Indiana m be � ❑� $� �s this property a residential rental property?
\ vacated (or this residence? If yes, provide ❑ Q✓ 9� bVould you like [o receive tae statements for this
con;Ylete add*�e_=s ef resic>r.ce being vacaced, eroperty via e-mail? (Provide contact information
induding county: below. Please see instructions%'or more information.
Not available in all counties.J
Addreu (Abm6er and SveetJ
a�"°� 5� - 03� o� o� �-
Cin•, Sm:e ZIPCade Counry
Rimoryproperryownerronmc[nome E�mail
Under penal[ies of perjury, 1 hereby certify [hat this Sales Disclosure, to [he bes[ of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance wi[h 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 Homes[ead Deduction is
beii fi d.)
.
SignaNreafBuyed �� Signam�eo/Buyer2/Spouse .
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Pnn:edl,egalA'ameofBurnl SignDo[e(M.e/OD� ] PnnuMLegalNameo�Bwer2/Spouse SignDale(MM/DO/YYYh
LasiSdigittojBuyer?/SpouseDriveh Smte Las[SDigi6o%Social5ecuriry
License/ID/OrherNum6er Number License/lD/OlherNumber
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