Homestead_CoffmanINDIANA�ALFS DISdOSURE FORM SDF ID: Pa e 2
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Maurice Do�l Attomev
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P.O. Box 703 Nbrtie Doll & Associates Ik
Addrat(NUmboand5aac) Campany
Newburah IN 47629-0703
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2924 East Nowaskie Road
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Vinranna IN 47591
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Under penalties of perjury, l hereby certify tba[ this Sales Disclowre, to [he best of my Imowledge and belief, is true, correct
o plete as reQ� red by�0w, and is prepared in accordance with IC 6-1.1-5.5, "Real Prope�Yy Sales Disdosure AR".
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: _. .. '.GIFANTEE S -?�'.1kPP.L'[fr&�10N'�EORFROP�iFTYs,'I�AX`�3EllkTGTiONS�,`3t!$N�[RS'?A�?I#IT�MS TffAT%/tPB�Ya�..,-=;-;��x��;c�'�
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2115 W CR350N
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Patoka IN 47666
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THE S�LLPS DIS�.OSURE iOAM MAY BE USED TOAPPLY FOP �[I'ALY D�IILTIONS FOR THIS PROPO(fY. IDPl7fIFY ALL OF THOSE THAT APPLY.
Y6S NO COIiDITON
� ❑ i. Will this property be the buyer's primary Q ❑ 3. Homes[ead
residence7 Provide complete address of primary � � 4. Solaz Energy Heating/Cooting Sys[em
residence, including rnunty: � O
2N 5 W. CR350N. 5. Wind Power Device
Addrm(Numbcand5trat) ❑ � 6. Hydroelectric Power Device
Patoka IN 47666 Gibson � � 7, Geothermal Energy Heaang/Cooling Device
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� Q 2. Does the buyer have a homestead in Indiana [o be � � B� ���s property a residendal rental property?
vacaird for this residence? If yes, provide ❑ 0 9. Would you like [o receive tae statemeri� for this
complete address of residence being vacated, property via e-mail? (Provide contact fnformatlon
includingcounry: below.Please 'ons ormoreinformadon.
available rn all coundes)
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Under penaltles afperjury, I hereby certify that this Sales Disclosure, to the best of my lmowledge and betief, is true, rnrrect
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure AQ". (Note:
Spouse informaUOn, Sociat Security and Drivefs Licease/Other numbers are uot necessary if no Homestead Deducdon is
being flied.)
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