Homestead_HouseSDFID:
Neporero(Ne Sa/a Dittlosure Form
General Manaaer
Title
501 Main St.. Ste. 101 Bosse Title Comoanv
Addr¢s(NUmbe�arsd5treeq
E-mail
2779 S 550 E 2229 S 550 E
Address(NUmberand5tree[J ( Address(NumberandSVee[)
Francisco. IN 47649 / Francisco. IN 47['i49
Under nalties of perjury, I hereby certify tha[ this Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and c�lete as requiy�ed by�aw and is prepared in accordance with 1,5 6-1.1-5.5, "Real Prg$ecty Sales Disclosure Act".
NGV 2 9 2012
Bu}�v 1- Name as opppurfon ronveyance davment
Lvnnville. IN 47619
�❑ 1. Will this property be [he buyer's primary �
residence? Provide complete address of primary
residence, induding county: �
aaa Q o� .sso,�
r'ddrm(Numberand5vee[ ,/ "/ O /� �
/-hdnGlSCO,�.t/ `�!�a�7 I C�LbSVn �
Ciry,SmuZIPCade Counry ❑
� ❑ 2. Does the buyer have a homestead in indiana to be ❑
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addr� (Nu mber and SveeQ
Ciry, Smre ZIPCode
Counry
TNOSE TNAT APPLY.
❑ 3. Homestead
�etg�}leating/Cooling System
5. Wind Power Device
6. Hydroelectric Power Device
7. Geochermal Energy Heating/Cooling Device
8. Is this property a residential rental property?
9. Would you like to receive tar statements for this
property via e-mail? (Provide contact information
6elow. Please see inshvctians%ar more informaCion.
Not available in all counties.)
«� -/a ��
name
- o�i,s.sv-o a S�
E mail
Under penalties of perjury, t hereby certify that this Sales Disclosure, co the best of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[". (No[e:
Spouse information, Social Security and Driver's License/O[her numbers are no[ necessary if no Homestead Deduction is
being f d n
/ % �, � r,Yx�c /1/l I�wl2.�
SignamreofBuyerl ��— —�7g�nam eofBuyer2/Spouse
Chnstian R Hnuce Fli�aheth M. Hrn�se NOV 2 9 2012
License/ID/OtherNumber Num6er License/ID/OtherNumber