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Preparerafthe5ale D'ndasvre Form
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Under penaldes of perjury, t hereby certify that this Sales Disclosure, to the best of my lmowledge and belief, is W e, corred
and �eya�lete as requir�d-by la�j and is prepared in accordance with IC 6-1.1-5.5, °Real Property Sales Disclosure Ad°.
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THE SllFS DISQ.OSURE FORM MAY BE USED TO APPLY FOR mtTAIN DmUC170N5 FOR
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� ❑ 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
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Addrea (NUmbv atd 53eG)
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❑ i� 2. Does the buyer have a homescead in tndiana to be
T� vacated for this residence? If yes, provide
complete address of residence being vamted,
inrluding munry:
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APPLY.
� ❑ 3.Homestead aaac��oo�
❑ � 4. Solar Energy Headng/Cooling Sys[em
❑ � S. Wind Power Device
❑ � 6. Hydroelectric Power Device
❑ � 7. �eothermal Energy Heating/Cooling Device
❑ ��o.�,'�s this proper[y a residendal rental property?
❑ Would you like to receive mx statementr for this
� property via e-mail? (Provide contact informatlon
6elow. Please see instructions for more in%rmadon.
. Notavaila6leinalicounties)
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Under penalties of perjury. I hereby certify that this Sales Disclosure, to ihe best of my Imowledge and belief, is orue, correc[
and comple[e as required by law, and is prepared in accordance with IC bl.l-5.5, "Real Property Sales Disdosure Ac['. (Note:
Spouse information, Social Security and Driver s Licease/OtLer numbers are nat necessary if no Homestead Deduction is
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