Homestead_Green (5) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
h i- V. elloap s
Preparer of the Sal DisdosureF Title
7010 3.s6 l t�
ress(Number and Street) • C pang
l'Negin,J 1/t/ 4,7( 76 ( /c , Selo Soo I
City State,and ZIP Code Telephone Number E-mail•E:SELCER(SVGRANTOR(S) __. __I__—._ _-- -_ _ ___L — •-_ - ' — -"--__
—Seller,k Name asappears ncon e°nce ocument Seller WIpmeasappears onconveyanc ooc meet
Address(Number and Street) ���� A,d�r�ss,(Numbe and rel ii
7;0 3 3Soc:), 1-3'
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 re ' d b law,and is pared in accordance with 6.1.1.5.5,"Real Progeny Sales Disclosure Act".
%� l/hbU lCl�D bC�
..Si nature of Seller Score of Seller/ n
Signature / fir'/l ti ' rs- V Kl-�0 5 10--/ -ti
Printed Name of Seller Sign Date(M,M/DD/YYYY) Printed Name of Se ler Sian Date IMM/oo/VY' m
,F.BUYER(SVGRANTEE(S)Y-?APPLICi1TION:FOR,PROPERTY_TAX^DED.UCTIONS=IDENTIFYALL.ITEMSITHATAPP.LY___-_ __ ___
ILA SSQLZ (xLLt Lt�ry N Jul)._
Buyerl-,tame as appears on conveyance document Buyer 2-Name as appears on conveyance dor ent 2 j ?7
)JD S s+or 440tH t p
Address(Number and Street) Address(Number and Street) DEC 'I.2 {Dg
P(ntn(ehov. . lA) -n&w -
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION • S s CONDITION
a ❑ 1.Will this property be the buyer's primary U ❑ 3. Homestead
residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System
residence,including county:
'730 -S Shr,.n04P ❑ Q S.Wind Power Device
dildress(Number and Street) , L ❑ Q- 6.Hydroelectric Power Device
'ertice- -00.1 S2kJ `(76-70 a6s0,1 ❑ ❑' 7.Geothermal Energy Heatin:, o; g Device
City,State ZIP Code County Imo.
❑ ID 2.Does the buyer have a homestead in Indiana to be ❑ IL3 8.1s this property a residenti. ntal property?
vacated for this residence? If yes,provide n ld 9.Would you like to rece' eit statements for this
complete address of residence being vacated, property via e-mail?(P • to contact information
including county: below. Please see instructions for more information.
Not available in all counties.) �t
Address(Number and Street) V d3
City,State ZIP Code County
Primary property owner contact name E-mail