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&D/ANA SALESIDISCLOSURE FORM SDF ID SDO ID 471785 Page 2.
Chandra Kepley
Prepo---, rer af the Sales Disclosure Form Title
Title 0 E Main Street Ste 102 Contract Processing and Title
IIIIP;dress(Number and&evil) Company
Plainfield,IN 46168- 317-837-5044 ckepley@contracttitle.com
City.State and ZIP Code Telephone Number E-mail
Secretary Of HUD Secreaty of Housing&Urban Development
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on convevance document
40 Marietta Street
Address(Number and Street) Address(Number and Satre)
Atlanta,GA 30303- •
1 City State,and ZIP Code oryt State.and ZIP Code
317-837-5044
Telephone Number E-mail 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".
Signature of Seller Signature of Seller
Pri”rnd/Urn.,nrCePr• gin,on f,am inn tyvv.v. Printed n,r77.of Calor C„„On.,.f v yip n envy,
F ; . .:.•‘-- ":" .NTE L APPLICATION FOR-PROPERTYTAX DEDUCTIONS-.IDENTIFY ALL ITEMS THAT APPLY', -- : , '.i.•.., •'-'-.. 1
Buyer I-risme nr• • on conveyance document Buyer 2-Name as appears on conveyance document
6301 W CR 100 S
Address(Number and Street) Address(Number and Street)
Petersburg,IN 47567-
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
.
YES NO CONDITION ES NO CONDITION -
0 Fl 1.Will this property be the buyer's primary 13 El 3.Homestead
residence? Provide Complete address of pri d'y �l �-1 4.Solar E - z •abn&/Coo\inXSystem
residence,including county:
-- --
3 3 5.Wind Power Device
Address(Number and Street) 0 p 6.Hydroelectric Power Device
IN ADAMS �l �l
� �� c_^ 7 Geothermal Energy Heating/Cooling Device
oty,State ZIP Code County
Fl �-l 20oc��hehuy�rbavcaho/n���eoUi»|o�i�na�obe �l ��l 8.|s this property aresidroda|rental yrope�y?
�� c-� . �� F� 9YVoo|dyou|iketoreceiveoaxoatomcn/sforrhis
vaca,e�h�r�bixre�id�o�e! |[ye�.provid� ~~ �� 9.
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) C^7y - 3—/SPL/0 / . 050^
Chandra Kepley cxep|ey@onovacmxo.wom
CL7,State ZIP Code County
Primary 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 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 ril Homestead Deduction is
being filed.)
Signature,/mv°,/ r Signature^/»per4vponm v- %)ign
IN
- 'rimed Leger Name of Buyer I
S*"ov�povm*nn *mxaLegal Name^ywp,,' \
Last 5 of Driver's State um5����/���� L�s���uu��. `
State /�5�m�
Social Security
| uu"oy/�nmo,mvm��r Number Lx,nuy/4mca«rxxm I |
•
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:P.REPARER _-._ °_. • . .:., - ".` . .. -- ,ti T ,p _ c t ;.
Preparer of the Sales Disclosure Form Tide
®Address(Number and Street) Company
City,State,and 2JP Code Telephone Number E-mail
`£ SELLER(S)/GRANTOR(S) i ._v,- . j tr -n-,, .':: a,` 2? ., . r ;_ ..,.
Seller I-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
Address(Number and Street) Address(Number and Street)
City,State and ZIP Code City,State,and ZIP Code
Telephone Number E-mail Telephone Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my know)• .:e and belief,is true,correct
and complete as required by law,and is prepared in accordance with C 666---1.11--�"Real Pr�:�a D�loirreAct"//�`�`�
Signature of Seller ' otur"e of Seller e,� •P//�,
%. 4, _ter ir �/ l z� G
Printed Name ofSeller Sian Date(MM/DD/YYYY) Pnnted Nam;.J •ler - Sian Date(MM/OWYY17)
F.BUYER(5)/GRANTEE(S) APPLICATION'FORPROPERTYTAX•DEDUCTIONS 4IDENTIFY'ALCITEMSTHATAPPLY- -" _ .-
3 e b - I '
Buyer l- one as appears on conveyance document Buyer 2-Name as appears on conveyance document
ID 30I 10 Co--66 - t OO S
Address(Number and Street) Address(Number and Street)
+exsbu rc
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 ❑ ❑ 4.Solar Energy Heating/Cooling System
residence,including county: ❑ ❑
S.Wind Power Device
Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device
❑ ❑ 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
n ❑ 2.Does the buyer have a homestead in Indiana to be El 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ ❑ 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)
City,State ZIP Code County
Primary property owner contact name E-mail