Homestead_Belcher (2)r
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co n,or, Honor enou SDI: In. Paee 2
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James G. McDonald, III Attorney at Law
PreParer of the Sale, Diselnrure Form title
120 S. Main McDonald Law Office
Add,ea(NUmberand Street)
City. Stara and LP Code Telephoe Number E -mail
E7SE
Y MO,- >rx i NR� I
. Personal Representative
Seller 1- Name a, appears amm� eedocvmenc
of the Estate o Robert V. Schultheis
W/v2- Nameas appmrzan mnveyanttd¢amen<
Ad Yvr§�any�dAys
be
Addrtu(Numrand Sb W:)
^�1�)`[ • -
/'IN1 /_
Ciry pk and de T
City, Smta and ZIP Code
_7,Pe
7c-z
Tdeahone Nvmbrr E -mail
Tdenhone Number £ -mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple a as required by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
na[um of Seller � •y/ Slgnamm o(Wler
GI
JARED BIRCH,
EIQi' 1fEQRP. It01?Elt!< Yr_ TrU'. f3EDi1�f0£} �ID• HrF1F. Y: 41sGHT :Eit1�3'AdTiAi?P,Y,Y._�A�� �r""�'�`w
Tina Belcher
Bayer I- Name as appears an nntedatvment
Buyer2- Name osappeart on conveyance accument
0 Box 294
Address (Number and Seeer
Pnrnka TM 4,7666
Addrm (Number and Street)
Ciry, Smrq and LP Code
Gry, Sid and LP Cade
Telephone Number E -mail
E -mail
THE SALES DISCLOSURE APPLY FOR CERTAIN DEDUCr1O O0. THIS PROPERTY. IDEHnFYALLOF THO TAPPLY.
YES NO CONDITION YES NO CONDITION
!.Will this property be the buyer's primary
3. Homestead
residence? Provide complete address of prim
[ 4. Solar Energy Hea ' oCling System
residence, including county:
❑ S. Win Power Device
b /�- CI�EQ�N ST•
❑ CY 6. Hydroelectric Power Device
�uq (N�mbe�rpn so- y
Y'VO/r /Y( 1 rt,/
7. Geothermal Energy Heating /Cooling Device
❑ S. Is this property a residential rental property?
Cit, Sme LP Code County
❑ [1l 2. Does the buyer have a homestead in Indiana to be
/
vacated for this residence? If yes, provide
❑ L7 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 inscructions far more information.
Notavailable in all counties.)
� �_30 /G o�.o
Addre„ (Nvmbc and Streer)
� - o a •� -ago • -
taan
Clry, Stae VP Code �'
Pn'mary property awnerrnom¢ name 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, )tnd is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note:
Spouse informal/1101n, Social Sean ty and Driver's License /Other numbers are not necessary if no Homestead Deduction is
being filed.)/
v
Sig yerl Signature afBvycz /sPaa,e
3- Z.ii "(/
Tina Belcher
Last 5 digits ofBuyer2 /Spouse Driver's State Lost 5 Digits of5oclol Semriry
License/lD /Other Number Number Licerue /ID 10ther Number