HomeMy WebLinkAboutHomestead_Keller INDIANA SALES DISCLOSURE FORM SDF ID: PagI 2
D.PREPARER
arista ■ • A CLOS,n9 Moo/Nailer
Preparer of the Sales Disclosur- arm Title
sot rnwii st- 1 Ste. tot 3osse) 711 e, Campo vu j
Address(Number and Street) company
EUi atY11)e1 IP�f 47105 O12 -421-•(.ton
City,State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTOR(S) - - i= - • •' . _ _ - . _
Seller I-Name as appears on comrey•nr}dac •ent Seller Z-Name as appears on conveyance document
1 9 -_ Li • C • • 2011
Address Number aa���nn•S tP) (b� ^ _ 1 ` Address(Number and Street)
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 y pl�requir by 1 w,and is prepared in acc d rice wit IC 1.1-5.5,"Real Property Sales Disclosure Act".
=ittureo uer ��LL %V�'fi' d !^I Signature of Sell
nted Name of Seller Sian Date(MM/OD/1117) I 0 Print-• •me n,tSrller Sian Date(MM/DO/WM
F:BUY.R S GRANTEE S -APPLICATIO OR PROPERTYTAX DE
THIS P:.'.• . • - OF THOSE THAT APPLY.
YES '. CONDITION ' YES 0 CONDITION
❑ 1.Will this property be the buyer's primary MIO la ❑ .Homestead
residence? Provide complete address of primary II mi g • ela • gy Heating/Cooling System
resider in uding ti I ntyf_ YGC_// ❑ L and Power Device
-"I FrciSc Ad (Number &I-eV��� 4 tz� 1!e 1 ❑ hydroelectric Power Device
�`Jl•• ❑ Geothermal Energy Heating/Cooling Device
ClryState Zl ode County
❑ I�� ° Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be
L4
vacated for this residence? If yes,provide ❑ ' 7•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)
_;._. .._:;Cade Caunry -0r2-Sa-030- •9/3 0/2
Primary property owner con tact 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 num•rs are not n•cessary if n omestead Deduction is
being filed ���
�w� _�� _■• . 'f.i % /
ofBuyerl `d nature of B `2 •a-. ^`
o° G eller �4- Son it . Kelte `P