Homestead_Hall (4):, ,
1\DU�A SALES DISGLOSURE FOR\f
ialry Perkins � ' � �
Preparero%thefala0is21vsvreForm .
202 N Shadeland Avenue
Addrea(NUmberandStree[J . � '
SDF
SDOID 7387295
Closer
ne�
Hocker6 Associates
Ciry�, Srnt4 and LP Code Te(ephone Num6er f-muil
The Secretary�of HUD � � � �
Se1leN��Nameasaypearsonronv¢yonaedocumm[ � Se11er2�Nameasapyearsomm�veyrtn<edorumen[
40 Marietla SVeet
Adcrrst(NumberandSbeaJ Add�ets(Num6erand5treet)
Ailanta, GA 30303- �
Ciry, Srau. ond2/PCaOe G'ry.5mre, md LPCode
Tele hon Number E-mull Teleuhoneh'umber E-mail
Und � penaldes of p rju , t hereby certlfy [ha[ [his Sales Distlosure, [o [he bes[ of my knowiedge and belief, is [rue, correc[
aqd��mp�ete as requ e by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
���1
9325 West 450 Soulh
Address (A'umber o�ASheetJ
Owensville. IN 47665
9gnvmrto/Seller
9325 West 450 Soulh
Addrecs (Number ond S V ee[)
Owensville, IN 47665
CirytSmtp andZlPCode
TNE SALFS DISCLQSURE FORN MAY BE USEU TO APPLY FOR CERTAIN DEDURIONS FOP THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
�x ��1. Will this property be the buyer's primary
residence? Provide mmplete address of F
residence, including county:
9325 WEST 450 SOUTH
Addre# (A'um5e� aIM StreetJ
Owensville, IN 47665 GIBSON
[iry, Smre Z1PCOde Counry
�� 2. Does the buyer have a homestead in indiana to be
vacated for this residence? If yes, provide
complete address oiresidence being vacated,
including county:
Address (Numbe� n nd 5[reeQ
Caunry
Q � 3.
Hea[ing/Cooling System
� Q S. Wind Power Device
� Q 6. Hydroelec[ric Power Device
❑ Q 7. Geothermal Energy Hea[ing/Cooling Device
� Q 8. Is this property a residential rental property?
� Q 9. Would you like [o receive ta�c statements for this
property via e-mail? (Provide contactin�ormotion
. or more in%rmation.
Not availabfe in a(I counties.)
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Under penaldes of perjury, I hereby certify tha[ [his Sa ure o e . belief is ct
and complete as required by law, and is prepared in accordance wi[h IC 6d.1•5.5, eal Property Sales Disclosure At[". (Note:
Spouse information, Social Security and Drivers Licen§e/O[her numbers are no[ necessary if no Homes[ead Dedutdon is
being filed�.)J/ �
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Pn"ntedLqalNameofBuyerl S�nDV¢.ryn/uD/YYY1� PrtntedLqalNameoJBuyer2/Spouse SIg�+�1a�e( M/DD/YYtI)
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Lirente/ID/OtherNum6er Number Lirense/ID/OtherNumber �
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