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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Preparer of the Sales Disclosure Form Title
77
Address(Number and Street) Company
?"/A/ce-refAt 2-AJ V 7 70
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City,State,and ZIP Code Telephone Number E-mail
'E.:SELLERMIGRANT ORCS);-41.' 4)'r)-. :lr:5T IT-':.• .4-;;e1ti:ti4 t,:i ,:l';Tfir 19. it'?"i''-tl.- .■+•j;!:rtV,0117.:.,l'r: T--- " •.•c
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Seller)-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
yao s hie,2 Z E71",
Address(Number and Street) Address(Number and Street)
PA)/Ai c e 1-e itt -CA/ V76 70
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller Signature of Seller
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Printed Name of Seller . Sian Date(MADDIDTITY) Printed Name of Seller ri pio Date(MANDOPITCY)
Ft-,BUYER(SUGICANIEE(SY47APPLICATION:FOR PROPERTY TAX DEDUCTIONS4IIIDENTIFYA Icl'ISLIAlkAP,PL. '11‘.:,k•,.. .V..::".-"s3:4%, .
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- -Name as appea on conveyan oat men t
---Ikeyeza Buyer 2-Name as appears on conveyanarumr5 2014
Address(Number and Sweet) Address(Number and Street)
fAam c ; 5 C.6 ./.A/ I/%eft 17 Innh •
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YES NO CONDITION I YEI±Sty-NO—GONDITIDS,_
2.."0 1.Will this property be the buyer's primary n 3.Homestead
residence? Provide complete address of primary arn 4,Solar Energy Heating/Cooling System
rfisidence,including county:
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$4149 /N/ G 5-au P4',Jc iStaj-Trti 4t7i/9 0 0 5.Wind Power Device
Address(Nymber an,d Street 0 0 6. Hydroelectric Power Device
OAT/1"edo .54-trk S ô42 ii-ine RAC q 0 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP-ode County
2.Does the buyer have a homestead in Indiana to be 0 8.Is this property a residential rental property?
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vacated for this residence? If yes,provide 0 0 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: tv.Please see instructions for more information.
14 -0 •-e-- - otaval le in all coun nes.)
Address(Number and Street)
_FA 0 C LI SC0, Z.lki ci -76q eze - 04 - 7- DO . oc:13. 6 04 —a/2
City,State ZIP Code re'a 4571— g 1 L S'e 1 6.1 County
t Primary property owner contact name E-mail