Homestead_Elaman:NDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
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LANA C. HARPER CLOSER
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19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES. LLC
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E-mail
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'E:SELLER S' GRANTOR S +,.'.,� "`?� _ •
DAMEL L BAILEY .IAMIE L BAILEY
Sefler I� Name asappean on ronveyance dorument Se(Ier2 - Name as appears m mnveyvncedacumen[
Address (Numberand Svee[J Address (NUmber ond Stree[)
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Under penalties of perjury, t hereby certify tha[ 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 64.1-5.5, "Real Property Sales Disclosure Ac[".
Signamre o(Seller 5{qnabrre of5eller
hinledNomea Seller Si nDate MNOD PnnledNamlo Se/ler Si qDale MM/OD
�Fr BUYER S GRANTEE S'- APPLICATION FOR PROPERTY TAkDEDUCT[ONS= IDENTIFY ALL ITEhiS THAT APPLY � '
RADLE S. ELAMAN
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THE SALFS DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIY DEOURIO\S FOR THIS PROPERTY. IDEA"fIFY ALL OF THOSE TNAT APPLY.
YES NO COKDITION NO COh
�� 1. Will [his proper[y be the buyer's primary ��_ 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heabng/Cooling System
re dena, includi county:
� � '� j� �,�A �.� � �✓ 5. Wind Power Device
�A ress(Numberand5treetJ . f / ,��� ❑ ❑./ 6. HydroelecMc Power Device
�-�(l�� �/v ��`�� ��'"`�'� � ❑ ❑� 7, Geo[hermal Energy Heabng/Cooling Device
Ciry Smte ZIV [ode Counry
d❑ 2. Does [he buyer have a homestead in Indiana to be � ❑� 8• �s this property a residentlal ren[al property?
vacated for [his residence? If yes, provide ❑ ❑✓ 9• Would you like to re[eive [a�c statements for this
comple[e address of residence being vaca[ed, property via e-mail? (Provide contact information
/ incl ding county: 6elow. Please see instructions for more information.
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Under penalties of perjury, 1 hereby cerlify [hat [his Sales Distlosure, to [he best of my knowledge and belief, is [rue, correct
and comple[e as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Act". [No[e:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deducdon is
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License/ID/OtherNumber Number License/ID/OrherNumber
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