Homestead_Young (11) •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - . - . . -
1 I (5 l._a ! . 1'
Pre . .a(the Sales Disclosure Farm Title -
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Address Number and Street) Compan
ar€uUt 3 uric' isle) 441 gcco
City,State,and ZIP Code Telephone Num er E-mail
F._ LLER S 'GRANTORS . _ ... ." t .r '�:= . _ z. K'':: 4:::-.:-...7" .i _ AI Y, n 3<-.� ' __
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Seller Name as appearn
071 conveyance document S 2-Nam( appears an conveyance document —St
ICkp n.Address(Number cc ^"ems I'�''I /_^ Address(Number and Street)
Telephone Number E-mail
Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
7C7-+)a nn dd complete as require by law,an is prepared in accordanceyyiyh .-1.1-5.5,"Real Prope ales Disclosure Act".
LA,t-4...-Th ( ` Q� .. S s_n-
�ynamreaf5eller namr • ' 1•
b�i01n D• N CsY%�{ OS�13�8I3 'I±' �v0`{t°{f l3 3
Printed Name of Seller Sian Da e(HMO D/YYYYI Printed Name.seller Sian Date(.MM/DO/YIYYI
F:BU ER(S)/GRANTEE(S)-`APPLICATION,FOR PROPERTY TAX'DEDUCTIONS JDENTIFYALL ITEMSTHAT-'APPLY-Z 9t_''.'::::_•(_ -1
Buygrj;N. ,e pears a a nveyance•acs mt� Buv 2t Name measappears on CO once docu (
Address Number and Street) 0 �7 / Address(Number and Street)
A/_ 'i _ .4 t 0 _ —4i 760
('&
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 YES NO CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ Er 4.Solar Energy Heating/Cooling System
Iovia res- en� nclydingounty: ❑ 2- 5.Wind Power Device
deras ( mberand tee) ❑ [� 6.Hydroelectric Power Device
dgCrev G f� T,.� ((�66o Cr
` ❑ 0.- 7.Geothermal Energy Heating/Cooling Device
City State Zl Code County I—v
El 2.....
B.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide ❑ 'L�1 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) VQe ' /�o
City State ZIP Code 6- I3-I3- 3W- to01 s14 _000
Ca.nO
Primary property owner contact name E-mail
Under penalties of perjury,1 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 ar t not necessary if no - om•ste- . Deduction is
being filed.) - /
ni. ..r.-/_ A "..5-,�, _ ._- _.p / • a
Siyy��s�e��ofB�uyErl . r7 Signature s :u ' 2/Spouse ���
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