Homestead_Hale (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Li.PREPARER _
Preparer of the Sales Disclosure Form Tide
Address(Number and Street) Company -
Gty,State,and ZIP Code Telephone Number • Email
E.SELLERS)/GRANTOR(S) _
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
Address(Number and Street) Address(Number and Street)
City,State,and ZIP Code City,State,and ZIP Code
Telephone 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 complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
PlgliteliW fSeller ` Sign Date DAN/DD/MT) Printed Name ofSeller Sign Date(MM/DD/rYYI)
BUYER(S)/GRANTEE(S)-APPLICATION FO PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
.STEd&cI (v. H,1t52
---Effi.TerrqimnearaPPearratreorrveyrmce darsununr------ Buyer 2-Name as appears on conveyance document
904 S. Ley wood LAH-e
le.
Add -J Number and Street) Address(Number and Street)
` RL Nle7oN� -Z.-- .
t1L76�D
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P:r•.. - . u--•% . L OF THOSE AP
YVID CONDITION YVitt CONDITION �
❑ 1.Will this property be the buyer's primary E
3. omestea r AUG Y 2014
residence? Provide complete address of primary ❑ C •. oar Energy Heating/Cooling System
residence,including county: � ! ❑ S./W
ind Power Devicey��r
R04 S • Meg wood 44d0e r: of rv/
Address(Number and Srt+et) ❑ LYdroelectricCHEWi&M4tUNTY AUDITOR
R
4/7070 67[ fon'
❑ 7, thermal Energy Heating/Cooling Device
City,Star IP Code County
( 2.Does the buyer have a homestead in Indiana to be ❑ B is property a residential 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
n luding coup : below. Please see instructions for more information.
:70 S 42 3Ra (ST Not available in all counties.)
Address(Number and Street)
OWeogisvtoc..c Tti, 646S0iti 076 -4?-/ W-co 3. 2/2-Od 2
City,State ZIP Code County
L/ 746 S Primary property owner contact name E-mail