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D. PREPARER
Lett ra
Preparer ofthe Sales Discloser orm 1Dde
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�rdress (Number and Street) I
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CuxStoN,.rdZlPCb6 Telephone Number Email
E. SELLERS GRANTOR S 5 r r
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Sd.e/J, Na Name as appea on conveyance doc,t
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Selgr2 -Nam suP36Tnvtyar`ce do en
t7Jt/.fi� oG N •1i
Address /Number and Street) / S� /
Address (Nu berand5veet)
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City, State,
Telephone Number E -mail
�e e�hone Number E -mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and con lete as required by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act".
Signature of Seger ature� ller
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Punted A' eller i e MM D/YYY1) Printed Nameo Seller Si Date fMM/ D
F ER S GRANTEES °- APPLICATIONTORP,ROPE .`TAXDEDUGTIONS IDENTIFYALCITEMSTHATAPPLY'``
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Buyerl- Namevs oppearso mmeyvnce dtxvmenj,
By'er2 -A'ame as appears on conveyance document
Adore (Non, eland Street)
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Addrass(Number and Street)
State and ZIPCode
Ciry, State, and ZIPCode
�
Telephone Number E-mail
Telephone Number E -mail
THE SALES DISCLOSURE FORNI MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS
PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION
❑ 1. Will this property be the buyer's primary
3. Homestead
residence? Provide complete address of primary
Heating /Cooling System
9015.
residence, inuding county:
Wind Power Device
6. Hydroelectric Power Device
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I YLIaIC ( L Y �} L1 7(&yq C` bt(
❑ 7. Geothermal Energy Heating /Cooling Device
❑ R. Is this property a residential rental properly?
City, State ZIP Code County
❑ �yrgy 2. Does the buyer have homestead in Indiana to be
❑ 9. Would you like to receive tax statements for this
vacated for this residence? nce? If yes, provide
via e-mail? (Provide contact information
complete address of residence being vacated,
property
below. Please see instructions for more information.
including county:
Not available in all counties.)
a/ ia- oao. 7 ;7- of 7
Address (Number and Street)
city, tate ZIP Code County
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:
Spouse information, Social Security and Driver's License /Other numbers are not necessary 4f no Homestead Deduction is
being flied.), \y '
S, nnatureol'Buyer gal( S{gnamreofBayer2 /5pouse
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Number Last 5 digits ofBuyer2 /Spouse Driver's State Last 5 Digits of5ocial Security
License /ID /Other Number Number License /ID /Other Number