Homestead_Johanningsmeier INDIANA SALES DISCLOSURE FORM SDF ID: Paget
D.PREPARER • <- - - -- - ., _
joh
nsof f E scrow Officer
Prepare:-of the Sales Disclosure Form Tide
800 Lily Creek Road, Suite 102 Freibert & Mattinoly Title Group. LLC
Address(Number codSbcctl Ce pery
Louisville. KY 40243 502-238-7500
CRT Smrc.and ZIP Cede rdcphane Number Etrall
1 E.SELLER(S)/GRANTOR(S) - ; - - - ' -.
=R K lac,c, S.I- min , : III A I--hG4 n_soi--
' Sel crl•Name csa eon on conveyance daps..-5 Seller 2'Nome as appea en conveyance dowmy
1 • • ,X J0Z6 5. Nimfrk ve•
I. Addr�(Namberand Sc-rn, Addr (Nenbcr and Street;
x N an..bstaA-t. Iasi 47639 • '
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Under penalties of perjury,I hereby certify that this Sales Disclosure.to the best of my knowledge and belief,is true.correct
and comp)/gte as requiredby(law.and is prepared in accordance with IC 6- .1-5.5,"Real Prope Sales Disclosure Act".ft LI
Sgnaturc ciSeiler / db / Sig:• e of Seller l
harcJ K . 1-1--i ,nson 5-25-)y Sk:r IN , . i-hirs t�-•0)s-/y
Pruned Nan.:ofIdler Sian Date I,n,oemTYl Pnotcd Name eIScilr Sian Dote PM/(ID/nttt
F.13 UYER(S /GRANTEE(S)::APPLICATI0 N:FORPROPERTY,TAX:DEDUCrIONS-IDENTIFYALCITEMS THAT;APPLY -•-!r
C ni- 250Inetinn,n <.rrloAtt.r kal —)oh,rlr, ri rnh4.Ce
Buyer1-Nene est-pearscn conveyance do a•.—e.: Buye '-Nem�appears Pa conveyance documehtj
Wool AdtAn-I Ok /00Q I\LYnnn G1
Adder s(Numterend 5ocetl Address/Wumber and Street/ .�
dalbstoAt TH VR63=1 H��6sf �d rt l h' y �4�.30
I TUE SALES DISCLOSUnnE FORM MAY BE USED TO APPLY FOR CERTAIti DEDUCTIONS FO R THIS PROPERTY.IDENTIFY ALL OFTH I SP
YES NO CONDITION I YES net CONDITION
goo& twill this property be the buyer's primary 3.Homestead - ' ED
residence? Provide complete address of pnmary ❑ (a 4.Solar Energy Heating/Cooling System
residence,including county: ❑ t AWL 3 0 2014
/a6a RnAM Cou_ -r- S.Kind Power Devl
j�4�``I'dras(ltember and Street) _ ❑ 6.Hydroelectric Power Device
#AA8STA0/7 4- .4:' 10434 e (a 5042 ❑ 7.Geothermal EnBg Heau,- •• -_ ice
Cit),State ZIP Cede County b r
❑ 8.is this prorct fes •e•' - 'be property?
2.Does the buyer have a homestead in Indiana to be , .,1 , Y AUD(�It
❑ vacated for this residence? If yes,provide ❑ 9.Would you like to receive tax statemens. ror this i -
complete address of residence being vacated, property via e-mail?(Provide contact Information
including county: below.Please see instructions for more in formation.
Not available in all counties.)
Address Plumber endScreed n(CO` CT-3CC L01 - \� 0
C,0•.State Z72 Cede County - 1` oY `�'/
Fnmcfy property owner contact nem: bmcli i