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D.PREPARER
SamarrJU Cuisa9er
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228 W. BrazO�rav &oaE�rav Tille. lnc.
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120 Mtlerson CR at]0 120 FnCe(son CR 41]0
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Under penalUes of perjurr, l hereby ttrtity tl�a[ [hit Sales Disclosure, m the Aes[ of mv ImowleAge and �elie(, is trve, rorrett
and comD�e[e as requi d by law, and is preyared in accordance with IC 64. �i.5,'Real Prap Sales Dist surc AtC.
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F.BUyERS GRAN'fEE -APPLIGITIONFORPAOPERTYTAXDEDUCI'IONS-I�ENTIFYALLITEMSTHATAPPL7'�
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TIE SUFS DISO.OAIItE iOM NM1Y 6E USED MAiPIY {pR
Q � 1.1V'i:l Nis prope!q� be the huyer's primary
resi0ence? Providewmpleteaddresso(primary�
ru{Gence, Indudir.g:ounry:
121] 5. WASHWGTQV AVE.
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Primxton. IN 4]Ei0 GIBS0.Y
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�� Z. Uoes the buyer have a hamestead in Indiana to be
raramdfar[hisresidence? Ifyes.proNde
compkce adcress af residenm being vamteA.
induding wunty:
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GSw.keuIIPfde sv.v�
A�RY.
Q � 3. Hamestead
� c� 4.SalarlinergyHeating/COOI1ngSystem
� �J 5. Wind Po�cer Devfce
� Q 6. HyJmeleeiic Po�rer Devia
❑ [�] Z Geo[hermal Energy Heating/COOling Devim
� Q B.Isthispmpemaresidenrialrentalproperty?
� c� 9. Would ym� IiRe m rMtice ¢c svtemmes far this
property ra e-mail? (Pmvi4e ro-:act in(onna6on
below. Pieox see Irtswctlons far morc in(orlr,otion.
Rot mvifable fn ai7 counnes.)
Under penaltles of per�ury, 1 herebycerti[y Na[ Nis Sales Disdosure, to the best afmy Imoxiedge and belief, Is true, mrtett
anA complere as requtred by law, and is prepared in accordance wIC61C 6-I.1-5.5,'Real Propem� Sales DfsNosure Ac['. (Nole:
Spouse Information, Social5emriey anA Drivers Llttnse/Other num6ers are nut necessarv if no Homestead Deducuon is
befngfiled.J ��
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