Homestead_Martin (3) •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Kelsey A.Quack Customer Service Rep.
Preparer of the Sales Disclosure Form Tale
6525 East 82nd Street.Suite 110 Statewide Title Company. Inc.
Address(Number and Street) Company
Indianapolis,IN 46250 317-806-7640 kaquack(ostwdtitle.com
City,State and ZIP Code Telephone Number • E-mail
.E:SELLER( S)/GRANTOR(S) _ _ -' __..
Federal National Mortgage Association
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
14221 Dallas Parkway Suite 1000
Address(Number and Street) Address(Number and Street)
Dallas TX 75254
Und�+-penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an'd iplete�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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S tore of Seller Signature of Seller
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Printed Na ie of Seller Sian Date IMM/DD%YYYY1 Printed Name of Seller Sian Date(MM/DO/YYYtl
%FTBUYER S)/GRANTEE(S)'_-APPLICATION FOR PROPERTY-TAX DEDUCTIONS4 EDENTIFY:ALL:ITEMS THAT.APPLYJ_ :'—
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Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
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Address(Numbei and Street) 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 THOSE THAT APPLY. Vv {
YES NO CONDITION I YES NO CONDITION 12. 9D7a
Q ❑ 1.Will this property be the buyer's primary �]- ❑ 3.Homestead /e e, . <
Q
residence? Provide complete address of primary ❑ Q' 4.Solar Energy Heatinggh 1.y y c(�l�,
resident ,including county: iV7)
5.Wind Power Device
to. r4 5 Slr /r! ❑ 6.Hydroelectric Power Device Ohio
Address and Street) ❑ U y b
0,--; ; ilr Iry Llf 7 bb> C r aS: ❑ O 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 2. Does the buyer have a homestead in Indiana to be
❑ Q, 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ IN 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.
NI / A Not available ' all counties.)
Address(Number and Street) N l r d‘_/94/._ 60,_ l -'O/' �cli 01
City,State ZIP lode County
Primary property owner contact name E-mail