Homestead_Bittner (2)SDFID:
DON 60WELL CLOSER
:i Preparer of the Sales Disclosure Form Title
and Street)
State, and ZIP Code
30S,C-eP A 1b1'P1e7('-Alr
Seller I - Name as appears on conveyance document
Address(Numberand Street) _
-z
tty�
FIRST ADVANTAGE TITLE LLC
Company
�F/.1 (Jl�c� I` 4itpiErRA
Seller Z - Name as appears on conveyance document
�O7
e- LA'a-e L- R r/J6€ CT
Address (Number and Street)
'r-(Av3S -R t7 I tQ t-i763 L9
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and c�!plpsete eguir by and is prepared in accordance wit om( ofs 1 �"Real Property Sales Disclosure Ad ".
J AV >1PlET2 -n (�til +blz0/t I �e -�Z �CSCI�✓Sif>iiere4 0�(/1V Viz
OSF'P H
Buyer 2 - Name as appears on conveyance document
Address (Number and Street)
City, State, and ZIP Code
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
CONDITION
❑ 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
7O% c i_A7e.EZ 2)oGr Cr
Address (Number and Street)
PAJAS7- QT- IN Lf %fo301
City, State ZIP Code County
❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
I d(on cs4:;4es .
�Address(NumberandStreet) I
t—vnroirROT, IN `f %& �ffSiON
Ciry, State ZIPCode County
CONDITION
-�n ❑ 3. Homestead
rgy Heating /Cooling System
❑ ® S. Wind Power Device
❑ 0 6. Hydroelectric Power Device
❑ ® 7. Geothermal Energy Heating /Cooling Device
❑ ® 8. Is this property a residential rental property?
❑ ® 9. Would you like to receive tax statements for this
property via e-mail? (Provide contact information
below. Please see instructions for more information.
Notavoilob
,�e in all counde .
dG
L BITTNK
Under penalties of perjury, 1 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 ". (Note:
Spouse information, Social Security and Drivers License /Other numbers are not necessary if no Homestead Deduction is
being filed..) (�
Signature ofBUyer] Signature of Buyer2 /Spouse
TIN
Printed
IIN
Number
License /ID 10rher Number
Printed Legal Name of Buyer 2 /Spouse Sgn Do,(MMIDDIWM
Last 5 digits of Buyer 2 /Spouse Drivers Suite Last 5 Digits of5ocial Security
Number License /ID /Other Number