HomeMy WebLinkAboutHomestead_Murphy INDIANA SASS DISCLOSURE-FORM . . Page 2
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Prepares of the Soles Disclosure Form Title
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Address(Number and Street) Company
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City,State,and ZIP Code Telephone Number E-mail
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E:.SELLER(S)/GRANTOR(S}}------ ` T_--- .._-_-- —______- —.-- -----
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Seller I-Nome as appears an conveyance document Seller 2-Nome as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
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City,State,and 2IP Code City,State,and ZIP Code
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Telephone Number E-mail 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 corn filet- . .-quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature./Seller' Signature of Seller
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Prin • ame of Seller "• Date(MM/DD/YrYi) Printed Name of Seller Sign Date(.101/DD1Vm
7,:UYER(S)'/.GRTANTEE(S) 01",L'ICATI0 NiFORIRI '. RTYLTAXi DEDUCTIONS IDENTIFY'A(I,iTEMS,THATAP,BLti
Buyer Pyr, as a ppears onto •nee document Buyer 2-Name as appears on comeyante document
AdaresIff0iimber aM Street) ifelle 7 Address(Number and Sweet)
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Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROP :- • LL OF THOSE THAT APPLY.
YES z. NO CONDITION NO CONDITION
❑ 1..Will this property be the buyer's primary [t]." ] 3.Ho ad
residence? Provide complete address of primary 0------P. 4.Sular Energy Heating/Cooling System
,1^ residence incld ing county: ❑ y� S.Wind Power Device
A J erand,saYl.Fj,eS •
Ladle?6 sits
❑ 9' 6.Hydroelectric Power Device
[1 7.Geothermal Energy Heating/Cooling Device
City.State ZIP e County
Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
❑
vacated for this residence? If yes,provide ❑ n9.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.
Not available in all counties)
Address(Number and Street) a /_ nU -075-3a, coo J 77 0 R
City.State ZIP Cade County N 1�"'v-7
Primary property owner cantina 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-file. )
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Si - cure oQuyorfr A. ' "- - 1 Signature afBUyer2/Spouse
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Number License/ID/Other Number