HomeMy WebLinkAboutHomestead_Lipscomb1\DIANASALESDISCLOSUREFOR.N SOFID SDOID 1388978 PaS�'-
D. PREPARGR �. - � - � � -
Samaniha Cutsinger
Ae�nrrro(NeSaloOvclosurrFO�m TiJe
226 W. Bfoad�ray &oacn•2v Title. Inc.
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E.SELLER S GFWNTOR S
Craiq Olson Pentaqon Fetleral Gretlit Union
Shca ]- Ku�,r w vppeun nm m�.rN�ar Joaumuu vNn� 2- Nmne ns �ppwn.��� ew�aynme Aarumm�
2930 EsenhowerAve.
Adcrea 1.vumber and S�rrtJ AEErtss (Nnm6rravd S�r�tJ
Alexandria, VA 2231a-
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Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the hest of my knowledge and belfef, is true, correct
and complete as required by law, and is prepared in accordance N•ith IC 6-1.1•5.5, "Real Property Sales Disclosure Ac[".
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F.BU1'ERS GRANTEES-APPLICATIONFORPROPER7YTN(DEDUCTIONS-IDENTIFYALLITEMSTHATAPPLY
htichael G. Lipscomb Rebecca D Lipscomb
B�ryei ]� Ncr.�e nv oppecrs on;nnvrwr.ce Ca�:nm[ 3uyer? � Numeas apprrn m� mmeynna oxumm[
5736 S. V�`asftirgton SL 5136 S. Washington St.
Addre:s (NumMronOSRert/ AEdrcas (Numbrr anCRreetJ
Somerviile, IN 47683- Somefvdle, IN 47683, IN 47683-
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THE SALES OISCLOSV RE FORM NAY BE USED TO APPLY i0R CErtTA1N OEOUCf10MS fOF iHIS P0.0PERT'. IDEPTFY ALL OF THOSE THAT,IPPLY.
YES ;10 CO.YDITIOF YFS NO CONDITIO+
XQ � l. Will chis property be the buyer's primary QX ❑ 3. Homes[ead
residence? Provide mmplete address of primary � � 4, Solar Energy Heating/Cooling System
residence, including caunty: � � 5. YJind Power Device
10066 EASY ST.
nna,�/xW:,x.o�ds.R9 ❑ Q 6.HydroelecvicPowerDevice
Oai�antl Ciry. IN 47660_ GIBSON � � 7, (;eothermai Energy HeaUng/Cooling Device
C1ry. Sm<Z!P [ode Counn
Q � 2. Dues the buyer have a homescead in Indiana to be � � 8� Is thfs property a residential rencal property?
vacated (or .his residence? If yes, provide ❑ 0 y� Would y�u like co receive tax stacemen[s for this
complete add: ess of residence 6eing vacated, property via e-mail? (Provide contnct informa[ion
indu ding counq•: below. Plense see instruc[ions for ma�e in�ormenou.
5138 S WASHINGTON ST_ Ab[ available in all mun[ies)
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Somern�e. IN a76B3 _ GIBSON �%� /���� ��O�-QQ� 3_ Q� �O
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himary A�PrrtY mw<r mnart ncne
Under penal[ies ofperjury, i hereby certlfy [hat th[5 Sales Disclosure, to the best of my knowledge and belie(, is true, correce
and complete as required by lae•, and is prepareA in accordance with IC 6-1.1-5.5, "Real Property Sales Disdosure AcN. (Note:
Spouse informatiou, Social Security and Driver's License/Other mm�bers are oot necessary i(no Homes[ead Deductlon is
being filed.) _
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