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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
I D.PREPARER
D)a ttheiti /ll,'xon
io
Preparer of the Sales Disclosure Form Title
r.„%lJPSf 614 le., Sf reie1 it/1ion c/ut., Re,
Ad s(Number 1a d�Street) Company
/f`nce /aril �N Y7/, 7 0 �1a 3 �`a33 /lixanecvansvilk, .e--
Ciry,State,and ZIP Code Telephone Number E-mail
E.SELLER(5)/GRANTOR(S)
Thane/sea(Frances) e, 5±ea1nq
Seller I-Name as appears on conv nce document Seller 2-Name as appears on conveyance document
r�
Ill( t" 1j roaA <v
Ad ress(Number and(treet) / Address(Number and Street)
f,nceL..• J. 2/7670
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".
ID
Signature of Seller Signature of Seller
Frair'is'ra (5-anres) e, Steilln 03-cs1-13
Printed Name of Seller 1 pion Dote(.11M/D0/1TYY) Printed Name of Seller Sion Date(MM/DD/Ynl)
F.BUYE' -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
'nber+ 6, Stel i n
-• .,,•as a.pears on conveyance document 1 Buyer 2-Name as appears on conveyance document
.2,2 7 S /rJ/o in re) e
Add/�Js (Number and Street) /� Address(Number and Street)
/
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 I e... ,Tl N
e- ❑ - 1.Will this property be the buyer's primary I 0 ❑ 3.Homestead
residence? Provide complete address of primary u H. 4.Solar Energy 'eating/Cooling System
residence,including county: ❑ R
LJQ 5.Wind Power Device
Address(Number and Street) ❑ g 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El M 2.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 ❑ 0 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.
of available in al counties.
Address(Number and Street)
Ciry,Smte ZIP Cade C. my .6," / J,- 07 - f/ 23 - sot / A / ' O ~l
�
*.Primary property owner contact name ...d
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
b., d) _
Si eoj:yerl a Signature ofBuyer2/Spouse
® O ee'* G' Ste Il1n6 03 -01- 13
Number License/ID/Other Number A,'A\\
1