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HomeMy WebLinkAboutHomestead_Madsen l ' INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER .. ;�„ y, . n?1 Stick--- MAti9`(2 Preparer of the Sales Disclosure Form Tine - JU 141v4 Address(Number aa;s1 Street) Company City,State,and VPCode Telephone Number E-mail ((`DJ17el 'E ELLER(S /GRANTOR( - _s 'T;„ _, `ft Lea SSeller l.Name as appears an conveyance dncumet,t Seller 2-Name as appears on conveyance document iI acc 61,,r4C'A 15,6./161 ¶oAY'�L Address(Number and Strey) Address(Number and Street) ate;; L!t.clt4l)lllt_ //�.�•)) Li 763 4riti^L s-.. 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�rre uured jby law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". 911tal 6l at`sri'L,FG—s Signature of-S{eIler r� G C, Signature ofSeller //'' (, ? tCakll (} � I�A fh3CR.L ( l (Ni / ` /'f3 bc&rti a- C.Iic 0.11 t- iQrc. 2' / ` 1J Printed Name of Seller Win Date(MM/DD/YYM Printed Name of Seller Sign Date(MM/DD/YTTY) F.BUYER(S)/GRANTEE(S .:APPLICATION FOR PROPERTY:TAX DEDUCTIONS=IDENTIFY ALI:ITEMS THAT APPLY. - '•;.. ='+:)_ So SV\\..•.t•. c,.I,L'Afj/` Buyer 1-Name as appears on conveyance document Buyer 2-Nome as appears on conveyance document na, lAlfi 11rCt� - Address(Number and Stre1et) Address(Number and Street) T6.�at" PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONOmON YES No CONDITION © ❑ 1.will this property be the buyer's primary 1,22 ❑ 3.Homestead residence? Provide complete address of primary ❑ ❑ 4.Solar Ene /C residence,including county: 1 1� ,1 ��1_ �v0 1 Ul-+ffm 65), „LA, `�AK l� 0tt 61, h /Y ( I r A ❑ n1 5.Wind Pow e� c� Inn ddress(Numbers str ) // ❑ L1 6.Hydroelectric Power Device inCG� l ��%(fl;('1 �'1a 4 0 i^ ❑ ❑ 7.Geothermal EnSipHea leAgooling Device City,State ZIP Code County ❑ si 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.Would you like receiv menu for this complete address of residence being vacated, property via e- ntact information including county: below.KAMM aka QiiiiititkYlsWAiNPFnformation. 'T// Not available in all counties.) �Y Address(Number and Street) a t) ,-09 -2'./ .303 -000 / &c)Q ael City, VP County a UO -Ciao 940074'-co ry, Primary property owner contact name Emall