Homestead_Beloat (4)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
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Brandv Alaniz Closing Soecialisi - REO Officer
Pre{wrer o(rhe Sa/es Disdorure Form Title
5600 Tennyson Pkwy #150 Telsi Real Estate Solutions
Addrest (Nwnberand Streee) Company
Plano. TX 75024
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e,Er:SELIiER S GRANTOR S_ s�i, � a,__ E; ;.��.. � c:;. . a:'s' T - •_. t.s _-?^,:
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Sellerl�NUmeasapyevrsoncom�eyuncedxument SeI1cr2�Nameasa yv
���� � ppmrsonronve ncedxument
1810 F St Andraw Plana
Address (Number and StreetJ Address (NUmber ond Svec:)
Santa Ana (:a 99705
Email Tele honeNUmber E�mafl
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 AcC'.
Signamre o(Scller Signamre o(Seller
PrintedA'omeo5elfer SianDare(MM 0/YYYV1 PrfntedNameo(Seller SionDa[eM.N/DO
,Fd?BUYER S` GRr1\'.TEE S��APPL;ICt1TI0NtE0R�PROPERTY TAX DEDUCTIO\S= IDENTIFY`AI.L';1TEMS THAT APP�l =,'!`� ""t`✓�
Nicholas Beloat �,ori Beloat
Buyer ]- A'ome as appean on conveyvnre dacument Buxer? - Name as appears om m�veyonm document
32�.z E Soni ���a � 5o;�f
, �4ddress (Nmn6er md Streer) pAAress (Numbe� ond Sveet)
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E�mail Tele honeNumber E-mall
THF. SALFS �ISCLOSURE FORM MAl' 8E USED TO AVPL1' FOR CERTA I Y DEDUCf10NS FOR THIS PROPER'fY. I DEYTIFY ALL OF THOSE THAT APPLY.
1'ES NO COYDITIO� 1'ES NO CO\DITIOY
� 1. Will this property be the buye�'s primary � 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling Sys[em
residence, including county:
> � [v� S. Wind Power Device
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�ddrecs(Nu%�` rand5vee[J ❑ v� 6. Hydroelectric Power Deaice
,' "u �"""' ^� ��0��� � '"� ❑ [�/ 7. Geothermal Energy Heating/Cooling Device
CIry.SmteZIP� de lounry
��. Does the buyer have a homestead in Indiana to be � �$• �s this property a residential rental piroperty?
vacated for this residence? If yes, provide ❑ �9• �Nould you like to receive tax statements for this
complete address of residence being vacated, property via e-mail? (Provide contact in�ormntion
including county: below. Please see instrucrions jor more in%armation.
A'ot available in a1I counties.)
Addreu (Number ond Svee[/
Ciry,SmteZlPlade Covn[ � �' /� � � 3 �OO OOO �/S D ��
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Pdmarv properry oirner rontac[ name E'�mail
Under penal[ies of perjury, 1 hereby certlfy 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 �vith IC G-11-S.S, "Real Property Sales Disclosure AcY'. (Note:
Spouse informatlon, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deductlon is
being filed.
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Slgnamreo(Buyeri ,�Igr mreo(Buytr2/Spouse
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Social5ecuriryNumber LastSdigitso�Buyer2/SpouseDriver's 5[ote LostSDigiGSO(SocialSecuri
License/lD/OtherNumber Number' Litense/ID/OtherNumber