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Homestead_Borchelt
INDIANA SALES DISCLOSURE FORM • SDF ID SDO ID 1791409 • Page 2 :D:`PREPARER;4 S44�`�� * ��-� -r p �� `��#s= s.4r.-'3..'s.`S Aedana C Cole Deed Specialist Preparer of die Sales Disehsure Farm Title 662 Woodward Ave. Title Source,INC. Address(Number and Street) Company Detroit,MI 48226- Cry,State,and ZIP Code 313106 adrianacole @titlesource.com Telephone phone Number E-mail :E?SELI ER(S)%GR,4NTOR(S) ' s i z es , e?ri .%. Theodore A.Borchelt Seller I-Nome asappears on conveyance document Seller Z-Name as appears on conveyance document 12728 S.Scottsdale Dr. Address(Number and Street) Address(Number and Street) Haubstadi,IN 47639- and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature a(Seller SignatureofSeller r+; nNnm.,ra, c;n"n Mvmnn a;" ex ",-"rwn R:BUYER(S)/GRAIYTEE(S) APPLI CATION`-FOR PROPERINJAX;DEDUGTIONS'''IDENTIFY.ALL ITEMS,THAIAPP:LYfi,' '7mal l Deborah K.Borchelt, Buyer I-Name as appears on conveyance document Buyer2•Name as a rs an can ppev vryanre document 12728 South Scottsdale Drive, Address(Number and Street) Address(Number and Street) Haubstadt„IN 47639- LY. YES NO CONDITION Y6 NO CONDITION © ❑ 1.Will this property be the buyer's primary ❑ 3 3.Homestead • residence? Provide complete address of primary residence,including county: ❑ © 4.Solar Energy He stem fl_1a8 S00-7N Sc,orr,samt £ DRtve ❑ © S.Wind Power Device Addrqs(N'umberand Street) e 18 S of ❑ ❑ 6.Hydroelectric Ps( er De ,IN ate sr AOT, rN N71o39 LLnrnoPllrn E ❑ ❑ • r' rot City,Slate ZIP Cole 7.Geothermal En- �• s. .eII8nvice County GIBSON 0 ❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ © B.Is this property a res a ential rental property? vacated for this residence? If yes,provide ❑ © 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) 1y, City,State ZIP Code a6-Z-I ` - .3D©- Do,• D ,(0-Da4 County Pnmary property owner contact name