HomeMy WebLinkAboutHomestead_Ford INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARYnEIR ±L
Preparer of the Sales Disclosure Form Title
3 West Jt6:fe Si-Pee f- hilt.. /Wrcn 1 /1lixcii Re,
Adryses s(Number,and Street) Company •
t l i)(r tcl-i _ V' 11/26. 70 cri!)- 3S- -61133 P/Xc)ieeu'1D512/ .112}-
Ciry,State,and ZIP Cod/ Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
..a P . at e i
Seller I- e as appears on conveyance document Seller 2-Name as appears on conveyance document
771%9 s /aa,3- u/
Address(Number and Street) Address(Number and Street)
Evens v i ll el i7) L)2&4)5
Telephone Number I 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".
tsar _ -
S nature of Selle Signature of Seller
')rr�c 60rre H- le ae etas 3
e PrldtedN afSeller-1 r'Sian Dates 4M/DD/YYYYID Pnnted Name of Setter I Sian Date(MN/DDm1T1
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
1di 0 / i rc I
Buyer l-Name as appears a. onveyanre document Buyer?-Name as appears an conveyance document
6170 6 IV, first" St. I
A�•'.ess(Number and Street) Address(Number and Street)
nee nsuWel .-171) V 7 6-&6
Telephone Number 1 E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TIIIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES- / NO CONDITION � YES NO CONDI1 ION I
t-"1 ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ 4.Solar Energy HI
✓ating/Cooling System
residence,i cluding county: I
.2 D 1.P AL / / sr$ S ❑ R. S.Wind Power Device
address(Number and Street) / ❑ tE ' 6.Hydroelectric Power Device
CIWE NS vi 4./._ , 7.7-_/,/ '4 7 61,5 C t'65°41 ❑ [Ti" 7.Geothermal EnI rgy Heating/Cooling Device
City,State ZIP Code Canny I
❑ R' 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 likeito receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please sere instructions for more information.
Not available in all counties.)
Address(Number and Street) Z to- 1-I-0 I - x`l I„J-/ t pace I -[ '3 o a, o�
a ca y as 04 ono _moo
Ciry,State ZIP Code County
Primary property owner contact name I E-mail