HomeMy WebLinkAboutHomestead_DejarnettINDIANA SALES DISCLOSURE FORM SDF ID:
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PrepareroftheSalrs D(srlasureForm
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Address (lVumberand Sd+eetJ
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Cfcy, Stntq and ZfPCode
Selfer 1- Name as appears oa cnrtveyance document
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Address� beran�Sb�eet)
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City, Sta an� `?Code
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2-Name
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Under penalties of perjury� I hereby certify that this Sales Disclosure, ta the best of my lmowledge and ef, is true, correct
and complete as required by,l�aw, an�§ prep�red in accordance with iC 6-�-5.5, "Real P�ty Sal� s�osnr�lc�t".,
s�e„em,� ofs�r�
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Clry, SLUt� and ZtPCode /
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THE SALES DiSQ.USURE FORM MAY BE USED TO APPLY FOR CERTAIN IIEDUC170NS FOR
I]DNDIT[ON
� 1. Will this property be the buyer's prunary
residence? Provide complete address of �
residence, including county:
?/�o�N��� �N .ST i� n' -���,T��
City, tatsZlPC County
❑ Z. Does the buyer have a homestead in lndiana to be
vacated fnr this residence? If yes, provide
complete address of residence being vacated,
including county:
Address (Number and Strcet)
Clry, Stcte ZIPCode County
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�UCTIONS- IDENT[FY ALI. ITEMS THAT APPLY
Buyer 2- Name as appears on aonveyance doarmerrt
Address (Number and Street)
City, Smte, and ZIP Code
Telephone Number �'m°�!
IS P . THAT APPLY.
YL+4 O CONDITION
� mestead
ergy Heating/Cooling System
� ��V�n Power Device
❑ u�6. roelectric Power Device
� � ermal Energy Heating/Cooling Device
� , s this property a residendal rental property?
� 9. Would you like to receive tax statements for this
properiy via e-mail? (Provide contact information
be�ow Please see insiructions for more informatron.
Not available in all cop�tie�) -�� / 6a
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8-mail
Under penalties of perjury, I hereby certify that this Sales Dfsclosure� 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 Dfsclosure Act". (Note:
Sponse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
bein ffied.)
� SlgnaNre uyerl SignatureofBuyer2/Spouse
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prfnGad Legnl Nam of Buyer 1 Slgn ate (M6(/DD/YYYY) Priated Lega! Name of 8uyerZ/Spouse Stgn DaGs (MM/DD/YYYY]
.
Number Last 5 djgits ojBuyer 2/Spouse Driver's State Last 5 Digits of Sodal Security
License/ID/OtherNumber Number Lianse/ID/OtherNumber