HomeMy WebLinkAboutHomestead_SimsINDIANA SALES DISCLOSURE FORM SDF ID: PdRe 2
D.PREPARER "
Preparer of the Sales Disclosure Form Title
702 S. I)JA'ini S�- Sell 4�aeP re a/ Est9 it-
... ress (h'mnberand Sveet) Company
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E -mail
E. SELLER(S)/GRANTOR(S)
V Inl0D L- (li eTA
Sellerl" Name as appears on conveyanced
Seller? Naineasappearsontonve acedotument
1 -79j6L Fox60YCV.tS� LAv,c
Address (,Number and Street) —G�
Address (Number aad Street)
So cc. FI- 33 -f `l
OT
E -mail
Telephone Number Email
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by lain, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
Signature oJSeller Signature o(Seller
Printed Name o Seller c' Out odm/09= Printed NamentSe/ler Sian Date MM/DD/rrM
F. BUYER(S)Z - 'APPLICATION FOR X DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
S
Bu r �Nameasappemsontnn eya cedacumeat
yer2- Numeasappeamoncomeyaneedocument
— ` Q .J
Address(h'umberand Street)
Address (Number and Street)
SKJ. g76yO
0 City,
E -mail
Tele hone Number E -mail
THE SALES DISCLOSURE FORM MAY HE USED TO APPLYFOR CERTAIN DEDUCTIONS FOR TH IS TY LL OF THOSE TAPPLY.
YES NO CONDITION 1'FS NO CON01710N
❑ 1. Will this property be the buyer's primary
I ❑ 3. Homestead
residence? Provide complete address o(prima
4.S e eating /Cooling System
residence, including county:
Z,in d i
❑ S. Wind Power Device
rely E• � 5 T
❑ 6. Hydroelectric Power Device
Address(NumbermutStreet)
Ff
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L� ZF( TOW rp)• 474-40 (Ti �SQN
❑ � 7, Geothermal Energy Heating /Cooling Device
❑ B. Is this property a residential rental property?
City. State ZIP Cade counny
❑ 2. Does the buyer have a homestead in Indiana to be
Will 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
below. Please see instructions for more information.
including county:
Not available in all counties.)
` 1(I
P eYIN ?IS \ Zr
Address (Number and Street)
City, State ZIP Code County
Primaryprapertyownertontact name E -moil
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 ". (Note:
Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
betagfiled.) _
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S tar e B Signature ofBUyer2/Spouse
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MIF
Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2 /Spouse Driver's State Lost 5 Digits of5ocial Security
License /ID /Other Number Number License /ID /Other Number