Homestead_Sevier/1NDDkNA SALES DISCUOSURE FORM SDF ID:
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Addim (Numbrraad S°eet)
_ Addran (Numberandstreet)
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E-mail
Telephone Number E+ V
Under penalties of perju 1 ereby ce that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete az require, and prepared in accordance with IC 6- 1.1 -S.S, "Real Property Sales Disclosure Act".
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GRANTEE ;APPIJ-DMQN FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
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BWQ 1- Namr as aPpmn an cvnveym,v document Bayer 2. Namem appears an conveyance document
Addnwffamb tr+eet)— Address(Number and street)
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Gry, Satz and LP Code C— ney, Sort and ZIP Cade
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E-mail T Number E -mail
RAIN DEDU TS PROPHENY. mIXTnY THAT APPLY.
THE SAS DISCLOSURE FORM MAY BE USED TO APPLY FOR m HI
YES NO 0DNDMON YES NO (T)NDMON
❑ 1. Will this property be the buyer' rimary
t❑ 3. Homestead
residence? Provide complete address of primary
lar Ener g /Cooling System
en ceG, in� c lruyd„itn,} g county:
residence,
y
❑ S. Wind Power Device
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e7 \� VJ
t0
❑ 0 6. Hydroelectric Power Device
Aedrm (xamdraMSneer)
�wK l �+.�. Ci�u �N 4%1590 �j b.S °t\
❑ 7. Geothermal Energy Heating/Cooling Device
❑ Is this property a residential rental property?
e9.
CIIy,SMW7JPCade County
❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
❑ 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 available in all counties)
'fc, of tf
Adds (Numberaad Saver)
Ory, state VPCode county
Primamm ry property ow,er contact name E -mail
Under penalties of perjury, l hereby certify that this Sales Disclosure, 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 -S.S, "Real Property Sales Disclosure Act'. (Note:
Spouse Information, Social Security and Drivers License /Other numbers are not necessary if no Homestead Deduction is
being filed.)
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Dna(MM/DD/MT) Pdaal Lyel NamenfBuyer l/Spmae Sgn Doa(MM /Dp/rrr1)
Last Sy digits of W;rl Drivers' Stare Last 5 Dlgia of Social security Number Last5digiaofBuyer2/Spouse Driver's Sate Last S Digia ofsocial Security
'lloerue/ID /ODieiNurnber Number License /ID /Other Number