Homestead_Peterson (2)INDIANA SALES DISCLOSURE FORM SDF lI
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MICrrHAEL E. MOORE 7�
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Under penalti spf perj t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is trve, correct
and o ple[e s i'equir d� d is prepared in a[cordance with IC 61.1 5.5, "Real Property Sales Disclosure Act".
Signamr of eller �� `,� �� l S' naNreofSelfer
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Atidress (Num6er and SrreeQ
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THE S,LLFS 015[LOAIRE iORM MAY BE USED TO APPLY fOR [EItTA1.Y DmUCf10�5 GOR TNE PROPERTY. IDEYTIFY ALL OF THOSE TTIAi APPLY.
[� ❑ 1. Will this property be the buyer's primary Ltl
residence? Provide complete address of primary �
residence, induding county: �
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ACdrzs(Num6erand�5'eet) 1 n1 �
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lin�, Sr�re ZIP lode Caunq.
Q' ❑ 2. Does the buyer have a homesiead in Indiana ro be
vacated for this residence? If yes, provide
comple[e address of residence being vacated,
including county:
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3. Homestead /Cooling
Q S. Wind Power Device
d 6. Hydroelec[ric Power Device
� 7. Geothermal Energy Heating/Cooling Device
� 8. Is this property a residential rental property?
� 9. Would you like to receive tas siatements for
this properry via e-mail? (Provide contoct in-
formation 6elow. Pleose see ins[rucdons for more inf
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Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and
comple[e as required by law, and is prepared in accordance with IC 6Q.1-5.5, "Real Property Sales Disclosure Ad". (Note: Spouse
informa[i n, Social Security and Driver's License/Other numbers are no[ cessary if no Homes[ead Deducdon is being filed.)
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