Homestead_HooverIPJDIANA•$ALES
STEPHANIE MILLER CLO
Preparu of[he SalaOlsdoture Form TiHe
8711 W HWY66 FIRST ADVANTAGE TITLE
Addras(NumberondStreeQ
E-mail
Seller 2� Narrldas appevrs on t'onveyance
Addres
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Under penalties of perjury, I hereby certify that this Sales Disdosure, [o the best of my knowledge and belief, is true, correct
and cqmplete as reqaired by laaq, �nd is prepared in accordance with�64.1-5.5, "Real Property Sales Disclosure Act".
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CERTd1.Y DEDURIO\5 iOR THIS PROPERTY. IUE\TI F1' ALL OF THOSE TNAT APPLY.
� ❑ 1. Will this properry be the buyer's primary �
residence? Provide complete address of pri ry
`i� `�I(�.� r��AS�'n l���nty:
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a Add� �mb;rand5 fe t¢ I� \ �-� I nl� b (��
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Ciry.SmreZIPCode ��-� Counry
❑ 1 7y 2. Does the buyer have a homestead in Indiana [o be
7 vacated for [his residence? If yes, provide
complete address of residence being vacated,
induding county:
Addrus(NUmberondSVeeQ
Code Counry
❑ 3. Homestead
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Heating/Cooling Sys[em
S. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is [his property a residen[ial ren[al property?
9. Would you like to receive tax sta[emenLS for [his
property via e-mail? (Provide contad in%rmation
6elow. Please see ins[rucdons for more informadon.
Not available in all counties.)
01�-o?o-/S��Gb?-�/ '�b'S'-ob /
Pnmarv oronerN owner mnmc[ name E-mail
Under penalties of perjury, I hereby certify [hat this Sales Disdosure, [o 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 Ad". (Note:
Spouse information, Social Security and Driver's License/O[her numbers are no[ necessary if no Nomestead Deduction is
LascSdigifsofBuyerl Dnver's
License/ID/Other Number
Number License/ID/OrherNum6er