HomeMy WebLinkAboutHomestead_Hardiman (15), �
INDIANA SALES DISCLOSiiRE FORM SDF ID: Pa e 2
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E. SELLER S GRANTOR
Seil 1-Name � ppears n�veyanced me�� Seller2-Namearappearsoacronveyancedocument
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Address (Nember aad Sb�t Addrexs (NumGer and Straet)
City, State, and ZIP Code City, StntG and Z(P Code
T e Namber &-mael Tek e Namber E-mail
Under penalties of perjnry, I hereby certify that this Sales Disdosure, to the best of my l�owiedge and belief, is true, correct
and complete as required by Iaw, and is prepared in accordance with IC 6-1.1-5.5� "Real Property Sales Disclosure Act".
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Signature ofSeller SignaWre ofSeller
Printed Name o Sdfer Sr n Date MM D Printed Name SeRer Si n Dau MM D
F. BUYER GRANTEE - APPLICATION FOR PROP�RTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
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Buy�-Na� ap�onmpyey�qdocument� Buyer2-Nameasappearsonconveyancedocumeat
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Ad (Numberand S J T Address (Number and Straet)
�r� n� c��-r� �1-�J 1..��(o %�l
E-mcil Tele hone Number &mai/
THE SAi.ES DISCLOSURE FORM MAY BE IISED TO APPLY FOR CERTAIN DEDUCf10NS FOR THIS PROPERTY. IDENTIFY ALL OF THUSE'i'HAT APPLY.
YES NO CONDiT[ON YP3 NO CONDIT[ON
❑ L Will this groperty be the buyer's prunary ❑ 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling System
residence, including county: � �
5. Wind Power Device
Address (Nam6er and Sireet) ❑ ❑ 6. Hydroelectric Power Device
c;ry,s�c�zrac e �ov�ry ❑ ❑ 7• Geothermal Energy HeatingJCooling Device
❑ � Does the buyer have a homestead in Indiana to be � ❑ 8• Is this property a residential rental property?
vacated fnr 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 availabie in atl counties.)
Address (Number and Street)
al�-ia-�-� -ab � ��3 a�$ oa
Cfty, State ZlPCode County
Primary property ownercoatact aome &mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and betief, 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
bei filed.)
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natvre o/Buyerl �� Signature ofBuyer2/Spoase
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Last 5 digits of Buyer 2 Driver's SWte Last 5 Digits of Social Security Number Last 5 digits of Buyer2/Spouse Driver's State Last 5 Digits of Social Searity
License/ID/OtherNumber Number License/ID/OtherNum6er
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