Homestead_Decker (6) _INDIANA SALES DISCLOSURE FORM SDF ID:
D.PREPARER Paget
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Prepare;afthe Sales Discs eaForm Title
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Address Number and Street) Co a
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City,Statq and ZIP Code
Telephone Number E-mail
E:SELLER -'GRANTOR-
Seller 1-Name as appeal-son 4weyance document
Seller on conv
/ S- 14 i• PP ryance document
ea(NUmberand Street) —/(-
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Telephone Number
E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my lmowledge and belief,is true,correct
and((cc/onIIijplleSete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
/Sign4t:recSe11£ T •
Y Signature o f Seller/
tinted Name ofSeller Sign Data DetI/DDLYI'M Printed NameafSeller
Sign DaeMM/oo/Y'-R-BUYER❑ GRANTEE(S J•—APPEICATION:BOR PROPERT Y TAX:DEDUCTIONS" .IDE\TIFYALL-PENSI THAflppLY - •
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Bayer I- e asppear anconveyance document Buyer 2-Name as a ears on conveyance document
Address(Number and Street) Address Number and Street
Fr- Lam.� `77G >'J
YES No CONDITION YES NO CONDITION •
Q/❑ 1.Will this property be the buyer's primary �❑ 3.Homestead
residence? Provide complete address of primary ,- 4'
residence,including coup ❑ �7 -•Solar Energy Heating/Cooling System
?l/ E n7 Tie s ❑ 0--1.Wind Power Device•
res Number and Street) �— ❑ Er 6.Hydroelectric Power Device
2i1/Cin;,/_-/tK Y7(6' V 6 6/6 5-6--.1-1
Ciy,smeZIPLoo•` County ❑ 7.Geothermal Energy Heating/Cooling Device
❑ 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 ❑ 9 7.Would-you like to receive tax satemenn for this
complete address of residence being property via e-mail?-(Provide contactinformation— -
including county: below Please see instructions for more information.
Ou'M Not available in all counties
Address Number and Street) O
L i ty,S'SL— - County a(9- R-08-301-003- -Oas?
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 no Homestead Deduction is
being filed.)
16 eofguyed Signature ofBUycrZ use
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. Number License/ID/Other Number
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