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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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:-0°,P,REPARERd`;� c:x�..vfi''. -.,�if_r.�nt?s-:-..�°.� - �'t>:�-°.l-r, obi:-.: _ .�:'�.'�., Syt�-:L.rs.ci�3z� ....a.,�_'`;"C.+N.n _..:�:�Z.a:. .
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Preparer of the Sales Disclosure Form Title
62//61 Ana,/ Cr., fir- ZZ
Addy (Number and Street) Company
/,C/.✓cEro / Z Y7690 e/2- 632-02/y
City,State,and ZIP Code Telephone Number E-mail
ETSEELER(S)%GRANTOR(S)�Z" s�'-a�ti#'+s '�4WAW—I 117 --i 4 , i r . ,yst rz , .,:..
'7� ?r_�2�L�'n. .. a_ lxki:,t f�si.•,55�'`�, :''C�-�'�..i a _-.''�`-tom:-
Seller l-Name as appears o conveyance document Seller 2-Name as appears on conveyance document
ZllO �1s1a-(M CA- 40 72
(Number and Street) Address(Number and Street)
INGE-MN (n( 47(
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".
Signature ofSerer Signature of Seller •
P0.'Irl e I-7--S%e/A1, 11- 22-2d 11
Printed Name ofSeller Sian Date(MM/DD/YYY1) Printed Name ofSeller Sian ate(MM/DD/rYY1)
F BUYER(S)%GRANTEE(S)1""AP,P•hICATIOWOR/PROP,ERIW aTAXIDEDUCTIONStIDENTIFYfAL'L!IT §:
II
'AP. • } ? Oilfit'i3)
)-Nameas • ..on conveyance document Buyer 2-Name as appears on conveyance document
K /E ap M%l/s DEC 3 30 2014
Address(Number and Street)
2_3 / W, /1orf-°n 51.
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES
Q' ❑ 1.Will this property be the buyer's primary 12" ❑ 3.Homestead
residence? Provide complete address of primary u H" 4.Solar Energy Heating/
/Gap CI j -1 N g7hb0 r/y/bS0{'I ❑ j 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ g• 2.Does the buyer have a homestead in Indiana to be ❑ Q $ Is this property a residential rental property?
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
including county: below.Please see instructions for more information.
114'..5(°d1 Not available in all counties.)
Address(Number and Street) 01•41 t /y -/8 - 3 0
3-000. 8°? 7 e02
City,State ZIP Code County
Primary property owner contact name E-mail