HomeMy WebLinkAboutHomestead_EvanstEFORM SDFID:
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Preparer of the Sala Disclosure Form Title
Address (Number and Street Company
City, State and ZIP Code - Telephone Number
E -mail
E. SELLERS RANTOR S - - - - - - -
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Selle,r]�-Na �eau �„ears on mnveyanncedocvment Seller 2- Name as appears on conveyance document
.td(Irpss (Number nd ,t Address (Number and Street)
City. State and ZIP Code — City, State, and ZIP Code
Under penalties of perjury, I I;ereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comolete as required)b ila%V aud'ls prepared in accordance with IC 6- 1.1 -S.5, "Real Property Sales Disclosure Act ".
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✓Buyer 2 - Name as appears on conveyance document
Address (Number and Street)
City State,
rummer E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
❑ 1. Will this propertt be the buyer's primary
residence? Provide complete address of primary
al
❑ ❑ 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:
Address (Number and Sweet
❑ Homestead
❑ Solar Energy Heating /Cooling System
❑ Ind Power Device
❑ hydroelectric Power Device
❑ �JiGeothermal Energy Heating /Cooling Device
❑ rL'1 /8. Is this property a residential rental property?
❑ g-"9. Would you like to receive tax statements for this
property via e-mail? (Provide contact information
below. Please see instructions for more information.
Not available in all counties.)
City, State ZIP Code loun I Z d / tiQ 7 l� '� a 3 CO
ry Primary property owner contact name E -mail
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:
'pouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
being tiled.) ^ ^
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Signature ofBuyerZlSpouse
1 Sign Date(NM /Dtl/VYYI) Printed Legal Name ofByer 2 1Spouse Sign DowrMApDD/YnY)
l Drivers State Last 5 Digits of Social Security Number
License /ID10ther Number r
Last S digits of Buyer 2 15pouse Driver's State Last 5 Digits of Social Security
Number License /iD /Other Number