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HomeMy WebLinkAboutHomestead_Loveless (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 -D PREPARER'-:. '': `r r.I'- ,{; .. Preparer of the Sales Disclosure Form Title MUST RE COMPLETED kSeller 1-Name as appears on conveyance d�jcumeen.t - Selig 2.-Name as appears on conveyance datum . •, r-1_t\t 4 ko--) f I"// �I\` 1 1, o J 4 ' l Address(Number and Street) Address(Number and Street) a � � r stR= 3 y ,,.1e CiO•,State,'nKb/t :S J -� N L 7 S /t� City te,�nd ZIP Code TeleWhone Number / E-mail Telephone Number E-mail Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and comp a as required by law,and is prepared in accordance with IC 6-1, 5.5," al Property Sales Disclosure Act". I ate- 7,�h�� (1_,,_, . Slgnamre of Seller Signature of Seller ,nci,o; 4- Apo- I-st5 ?-- 9 -DID/y �`K I Lb,--=Rl --",-5J F5 'Li .iLi Printed Name of Seller Sian Dote(NH/ODATYY) Printed Name of Seller Sian Date(NN/DDAllll :Fi13UYEk(S1/GRANTEE(S)=APPLICATION FOR ROPERTYT AX•DEDUCTIONS`'IDENTIF.YALE ITEMS THAT APPLY:::.!" ' ;• " . ppO1y��2t .5;,st cacst Buyer I-Name as appears on conveyance document Buyer 2-Noire as appears on conveyance document 12:1 ( C. \OZS 5. Address(Number and d Streeet)) 1 r_ Address(Number and Street) lb■`Ua\wJ4 I.VF t� THIS PROPERTY. IDENTIFY ALL OF T HOSE THAT APPLY. 1 Y�ES NO CONDITION YES NO CONDITION /1 ,�l vj ❑ 1.Will this property be the buyer's primary �� 3.HomesteadIBSON C UUNTYAU residence? Provide complete address of primary n 4.Solar Energy Heating9Coohng SyLQJ oR residence,including county: ADDRESS MUST HI: In Er S.Wind Power Device Address(Number and Street) COMPLETED ON ALL ❑ u 6.Hydroelectric Power Device DISCLOSURES ❑ Er :reothermal Energy Heating/Cooling Device City,State ZIP Code (NO EXCEPTIONS) County I❑7. 3.Is this property a residential rental property? ❑ ® 2.Does the buy. Ito be L_I vacated for this residence! II yes, provide ❑ 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact infornmtion including county: below.Please see instructions for more information. 12T(.‘) E . Lo-t 3 . Not available in all counties.) Address(Number and Street) a�S,✓d k-,, _r4 4-7(aDO c21`)Gra ab-a1-3-303:7o). ibo W( Cu,,,State ZIP Code County T .,�}r Primary property owner coutaigme ,� , t ,,� E-mail IF THE HOMESTEAD BOX IS CHECKED s: TI-IEV HAVE NOT COMPLETED THE DIGIT LICENSE # SI THE 5 DIGIT SS' - THEY WILL NOT RECEIVE THE l-IMSI D