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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Debbie Carpenter Customer Service Rep.
Preparer of the Sales Disclosure Form Title
6525 East 82nd Street. Suite 110 Statewide Title Company,Inc.
Address(Number and Street) Company
Indianapolis, IN 46250 317-806-7640 dcarpenter @stwdtitle.com
City,State,and ZIP Code Telephone Number E-mail
EFSECLER(S)F/GRANTOR(SILI:' ' =s--_— .. 17Th 7 . - 777T- M .--_
Feel raI National Mortgage Association _
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
14221 Dallas Parkway Suite 1000
Address(Number and Street) Address(Number and Street)
Dallas TX 75254 - -
Telephone 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 complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
� e of Seller - ��/ -,/J Signature of Seller
:Printed Nam-of Seller Sign Date(M.4/DO/I111) Printed Name of Seller Sign Date(MM/DO/YIT)
EF:UYER(S %GRANTEE(ShAPPLI ATIOCN.FORP,ROPERT1YAYAX.DEDUETIONSLIDENTIEY_ALL;ITENSjTHATIAP,FILK ,
61//77,6,,,y7 7 CA'// 5 _
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
Y-4{.3 E,5SQC
Tddress(Number and Street) //�� //// Address(Number and Street)
C/c Lfr ' / O r dA
Telephone Number 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 YES NO CONDITION
` ❑ (1:1Nill this property be the buyer's primary [ ❑ 3,Homestead
it
residence? Provide complete address of primary ❑ Solar Energy Heating/Cooling System
residence,including county: ❑ a
5.Wind Power Device
Address(Number and Street) ❑ [ :4 e Hydroelectric Power Device
J iff t Ge thermal Energy Heating/Cooling Device
City,State ZIP Code County 11
(1 ❑ s this property a residential rental property?
ii6 ❑ ie. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide ❑ 9.Would you like to receive tax statements for this
complete address of residence being vacated, (property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
30/ V. 4..:hca" Not available in all counties.)
Apr (Nu ran tree!)
l ,,, 97/39 61,Zc a, b _z I MaCOCWL3a30o /
City,State ZIP Code County
Primary property owner contact name 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 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 if no Homestead Deduction is
being filed.
csIg uture ofBuyerl T /^ 4 c c Signature ofBuyerl/Spouse
__
LustSdigits.a/B- enDrivers`State2=PastS7DigitsofSoatinSerursgNrnbZ 0 Last S digits of Buyer 2/Spouse Driver's State Last S Digits of Social SecuritlC\
License/ID/Other Number Number License/ID/Other Number \�