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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Setter 2 - Name as appears on conveyance document
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Address (Number and Street)
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Telep hone Nonaber E -mail
Under pena I I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
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and compli/ je#reLy'law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
a atur!o Signature of Seller
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Printed Name (MMIDDIYYYY) Printed Name ofSeller Sign Date (MMIDDIY"
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Buyer 2 - Name as appears on conveyance document
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Address (Number and Street)
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E-mail
Telephone Number E-mail
PRO HAT APPLY
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FORT IS PRO HATAPPLY.
YES NO CONDITION NO CONDITION
1. Will this property be the buyer's primary
3. Homestead
residence? Provide complete address of primar�c
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❑ S. Wind Power Device
6 Hydroelectric p we r DevIce
❑ 6. Power Device
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❑ , 7. Geothermal Energy Heating/Cooling Device
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E) 8. Is this property a residential rental property?
City, Stow ZIP Code County
0 F-1 2. Does the buyer have h estead in Indiana to be
1:1 9. Would you like to receive tax statements for this
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vacated for this residence? If yes, provide
complete address of residence being vacated,
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property via e-mail? (Provide contact information
below. Please see instructions for more information.
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Not available in all counties.)
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City, State ZIP Code C, ty
Primary property owner contact name E-moil
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, cial Secu and Driver's License/Other numbers are not necessary if no Homestead Deduction is
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bei gfiled.
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Sign Date (MMID
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Last 5 digits ofBvyer 1 Drivers State Last 3 Digits ofSocial Security Number Last S digits ofBuyer2lSpouse Driver's State Last 5 Digits of Social Security
License/ID/Other Number Number LicenseliDlOther Number