Homestead_HarrisonINDIANA SA /SDISCLOSURE FORM SDF ID:
Page 2
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Address (Number and Saear) ccunp.ry
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City, Store. and ZIPCode Telephone Number E -mail
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Seller Name as appears oa conveyance document
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Address (Number and Street)
Address (Number and Street)
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City. SWte and
City. Since, and ZIP Code
(1PCade
E mail
Telephone Number E-mail
Under penalties of perjury, I 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 6-1.1-5.5, "Real Property Sales Disclosure Act".
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Signature ofseller P4C--S ID C- 7' Signature ofSeller
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Printed Name ou(Seller Lqu Date (MMIDDIYYYY) Printed Name ofSeller
?F BUYER BUYER(S' /,GRANTEE ' -WPR UC ATI0N'F0Rbff6UCTIdNS WNEV REM - -S,�� �46EK TIM ku -out8mwff WV AP -V k -Y' 2
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Buyer 2- Name as appears on conveyance document
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dress
1W(Number and Street)
Address (Number and Street)
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cm, S t�ZI P C�ode
City. Stale. and ZIP Code
Tale ,hone N..be, E -mail
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THE SALES DISCLOSURE FORM MAY B E USED TO AF PLY FOR C ERTA IN D ED UCTI DNS FOR TH IS PROP �Itrl% IDENTIFY ALL OF THOSE THAT APPLY.
YES No CONDITION YES NO CONDITION
❑ 1. VVill this property be the buyer's primary
W ❑ 3. Homestead
residence? Provide complete address of primary
❑ N 4, Solar Energy Heating/Cooling System
rgde,��= county:
E] Ig S. Wind Power Device
❑ LM 6. Hydroelectric Power Device
Add
-610 (Qvj
77 (a (42 D
E] [2 7. Geothermal Energy Heating/Cooling Device
E] (�o 8. Is this property a residential rental property?
Cirjt State ZIPCoda County
2. Does the buyer have a homestead to be vacated for
this residence? If yes, provide complete address of
residence vacating, including counLy:
Address (Number and Street)
Cnv. State ZIP Code ca..cr