HomeMy WebLinkAboutHomestead_Meny (8) INDIANA SALES DISCLOSURE FORM SOF ID: .- . - Page 2
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,Preparrrofthe Sales Dadasure Form n // //// 1 )
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• Address(Number and Street) Company
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CBy,State,and 9P Code - Telephone Number • E-mail
• i SELLER{S)/GRANTOR(S) aa:n?F� `L'�r rlat 'x. 4Wili .: s*' -` .a,'
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' S.1s.,-Name as appears on conveyance document Seller l-Name as appear,on conveyance document
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Address(Number and Street) ��OI _ Address(Number and Street)
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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 omple - required by Iaw,and is prepared in accordance`with IC 61.1-5.5,°Real Property Sales Disclosure Act°.
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Signature of -lee . Signature of Seller
- - 3/1 4113
Printed Name ofSeller Sign Date(MM/DD/YYYY) Printed Name ofSeller ' Sign Date(MM/DD/YYn)
:F BUYER GRANTPF(Sr=-APPLICATION:EOI2 PROPERTY;:TAXDEDUCTIONSfIDENTIEYiA LITITEMS:THATsAPPLY& - W:
. - r ( 60 L-us. L . . 111 ?/Of . . -
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Buyer 2-Name as appears on conveyance document
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Add is(Number anciStreet),• 1 u Address(Number and Street)
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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.
YTS NO CONDmOY -
[ ❑ 1.will this property be the buyer's primary []' ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0" 4.Solar Energy Heating/Cooling System
residence,including county:
❑ a 5.Wind Power Device
Address(Number and Street) ❑ {3' 6.Hydroelectric Power Device
City,STate LP Code Counry ❑ Er 7.Geothermal Energy Heating/Cooling Device
❑ 0.7 2.Does the buyer have a homestead in Indiana to be ❑ $ Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ D' 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.
Not available in all counties)
Address(Number and Street)
Ab, 18- 36-3 op - ooa .0ZLi 8-61Y
City State VPCode County -
Prirriary 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 61.1 7.5.5,"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 led:)
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Stgnature afBuyer' *nature ofBuyerl/Spouse
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Number License/ID/Other Number , \N^\
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