Homestead_Williams (41) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Preffithe5ales Disclosure Fonn5t csk tO' Title Q CA- • r/� /,
Ad (Num errrAaandSweKr)_j'_1 Coat") 7111//LLJJff..CC„ (.�
/CI,V�S LIu Q. 41708 r L1 etb
City,State,and ZIP Code Telephone Humber E-mail
E:S LER(5)/6RANTOR(S - . "
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• er Nag appears on conveyance�d ent /� Seller 2-Name as appears on Conveyance document
A -i'NuumberSand trre(/t)�J^f^� \ Li-7(0270.
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Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as red bylaw,and is preps a 'n accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
" n re of Sell •JOc�l1 Signature of Seller L. 6vancou(
Printed Na a Seller Sian Bate(MN/DO/M) Printed Name ofSN/er Sian Date(MM/UD/YYYYI
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-.IDENTIFY ALL ITEMS THAT APPLY_,, _
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Rimer I-Name as app on cony docv ent Buyer 2-Name as appears on conveyance document
Address Lt.)(Number and SVpet/� . �7-(g�` Address(Number and Street)
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THDeE T t PLY.
YES NO CONDITION I YES NO CONDITION ED
3--❑ 1.Will this property be the buyer's primary El---"0 3.Homeste
residence? Provide complete address of primary ❑ ❑—.Solar Energy Heattiing/gCooling System
r )3 Gresidepce,-iand ing cou n , ❑ -�Wind Power Det'7t2 ` 0 2014
Lf�,. j(vAmbreJan Sweet) •'� el Go-7o / ( �� ❑❑ 3--6.Hydroelectric P wer Device
17�tt'r`" (�'1 IIIJ 7.Geothermal E ooling Device
City,State Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this R ct�ithiEt(aPt@ioldlg Device
y?
vacated for this residence? If yes,provide ❑ LI 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)
a6- 1a-1 g— 3N- 003- a 9
City,State ZIP Code County
Primary property owner contact name E-mail