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Homestead_Hollingsworth (2)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ti- D.PREPARER ,..�,.... .i :.:�-_ ,_: .':" , ..h=��e :. r 3 �...., � - , t "_A< ' W/ " 3 © P2 Prepares of the Sala Disclosure Form .,t Tide / / 7oz S. 71/.//46 Sf . MPe.Ks teitl y Addras tuber and Street) C Company / 4/Nce Street)/ 1r• 5(77o 3R -,0777/ laevv5�1tfv City,State,and ZIP Code Telephone Number I E-mail// "lee/s feeffy a)/ws/y4L4J,Cori 4E.SELLER1S1/GRANTORS),r_! -:=3 �`. s r-i o t -± ...-:,` ,. s. '-•-r- - z ti. _ 3 RofseT ok f,,/ez 12. fl?eefs Gun, a--.ru apneas on convryaneedc-+•m_' Seler 2-N e as appears on conveyance document ff,?l3 E. 2 5 g765 E. aso f, I Ada^^ai�number and and Street) / Address umber and Street) I refrAitr,o1o2 Xt'. 41747,0 ORk1Altxi<Gf X?t 47e4.0 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowl-d: • and b: i true,correct and c • -- . .s requir-d b Jaw and is •repared in accordance wi t. iii4� '" . 'ro - -,-s '46.H. t ?•re Act". •—,.i ' 1. L!`✓ \ • .i.12Pi t� ' A s.Li tnatu fSell Sgnature o —1 I gdbrei 4. More k3 Printed Name of Seller Sign Date(MM/DO/YYn) printed N.!!! Seller I Sign Date(10/OD/MT) :F.BUYER(5)/GRANTEE(S)=APPLICATION FOR PROPERTY TAX DEDUCTIONS=IDENTIFY ALL:ITEMS,THAT:APPLy2-: :r`.v .-_:wt&,`_ Terri L, 1k/l;,u1sswoe'l-(, CAAeles 41. /Ialltc&oc-,cf h • Buyer I-Name as appearson conveyance meat Buyer 2-Name as appears on conveyance document.' 7/3 5 t5rrn i,t)"he y St • 7/3 S. tS'In N A- St . Add (Number and Street) i� Add�s,(Number and Street) I itti; ce {4w1 A-' 417/a 2D rienveefan.1 , 1 4 ? 6, 7a THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDFNT(FY ALL OF THOSE THAT APPLy� YES O CONDMON NO CON N I �ttaayygg ❑ 1.Will this property be the buyer's primary C [tn ',Homestead residence? Provide complete address of primary L- ' ,,(1,3 ❑ Solar Energy Heating/Cooyl ys(Cat residence,including county: I t G 18 5o/v ❑ (rid Power Device Address(Number and Street) ❑ ydroelectric Power De ' t -44, 2/3 5. ,SemiNge St, �eiNCCfoi' i corm ISOR • cty,smn➢PC / 7¢onryy ❑ Geothermal Energy Heap •0.b• rt:'p ❑ Does the buyer have a homestead in Indiana to be ❑ s this property a r Wsel*I�ental property? vacated for this residence? If yes,provide ❑ 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) In ,b /11Peks 60.-I a-b7- -„9 1`9 City,State➢PCode County Primary property owns contact name 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