Homestead_Brown (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
0 PREPARER. ` ; =—p
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Preparerof the Sales DisclosureF m Tide \
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Address(Number and Street) ompany
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City,State,ancl ZIP Code Telephone Number
E-mail
]E:SELtiER(S)/GRANTOR(S):___ __�.� '- ' "-�"-
Seller l-Name a pears on con veyaltce document Seller 2-Name as appears on conveyance document
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Address(Number and Street \3 Address(Number and Street)
Under penalties of perjury,t 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".
Si na[ureo Seller ig r td. G
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Printed Name. •' S� Date(MM/DD/YITV) I Printed Name of Seller Sian Date IMM/DD/YYYY)
.F.$UE (S)/GRANTEE(S)',A1PPLICATION,'.1IRPROP,ERTYTAXIDEDUC TIONS?lDENTIEYALLITEMSTHATAPP,LX___ _-__
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,y.,_ -,'. 0500,..rs on conveyance docu Buyer 2-Name as appears on conveyance document
Addre\sss(Number and Street)\ - Address(Number and Street)
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO. I •' • •' • OF THOSE TN. •'t71'.
YES NO CONDITION YES NO CONDITION 11 �D
Er ❑ 1.Will this property be the buyer's primary Q' ❑ 3. Homestead
residence? Provide complete address of primary a...au— • _ . i7 Heatinjdia n stem
residence,including county: 11J L °11J14
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5.Wind Power Device
Address(Number and Street) r ❑ ❑- 6.Hydroelectric Pow/ Device,
Q tr),LL- M ❑ 2- 7.Geothermalt �'it 1• awfOrt S.ng Device
City State ZIP Code County I� pp AlIu
❑ 2 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residentiaef+fdDp7@}prty?
vacated for this residence? If yes,provide ❑ 2/
J 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) £ —/54/?-120/-000• 9c/ _. O0 7
City State ZIP Code County C
Primary property owner contact name E-mail