Homestead_Crowley INDIANA SALES DISCLOSURE FORM SDF ID:
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Santhosh.A DEED PREPARER
Pr evens of ale Solo Dat ysase Form
Tide
1000 Abernathy Road NE„ Building 400,Suite 200 PREMIUM TITLE SERVICES,INC
Address(Number and Sates)
etxponi
Atlanta.GA 30328
cy,sa:r,anla)Cade (7701672-7007 santhosh,aealtisource-com
re.ephoce Number
E-mail
E.iSELLER(S)/GRANT OR(S)-t •i31' .' tT(Ti '2 ri z:.,i',S'i'.- .s_,,. . - -
as
•- - •afire a er - 1 k11i1_LRs 1 h.}- ._ 3 ..,y.-"=i.;J Yf.-_g..T'.a
Seller 1 Nome asp 1 VI 1
appears conveyance doamenr
Seller 1-Name as appears asc.:rgo.:ce docume-:
C10 Ocwen I nan Sow g I I C 16881 Wnchirg inn R qd Sure 10Q
Adores(Number and Srea)
sddrca(NZ-ter oral St-en)
and com lete as re icod-by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act'.
Sigma eD/,S'eller
UI enE Doleine Car aCAlszy mtt ,,.,a,,� / _ Si„�:,reofSen.:
Printed Name ofSeg� oe n `
Sma Daze OW, DA I P=-ad Aeme aSeae
Sian Dare tLneinD/W,71'F BUYEt(S)/GAYTEE(S)741APPLICATION,FOWPROPER
. .TAX-DEDUG77oN5=IDENTIFY%ALLYTEMS•THATAPPLY:<,:s 5? ,:`e:
Tara L Crowley
Ityc 1-Nane as appears an cam-pence daeume,:
A}e P.tiame as appear,on=rweye-ce:a-..-en:
605 East BrUmmitt Street
Address(Number a:dSeeec)
M1;:rma(,':umber and Sze n)
YES NO CONDITION FEB
❑ 1.Will this property be the buyers primary ❑ 3.Homestead FEB 1-g LU
I 606 residence? Provide complete address of primary ❑.residence,including county-: 4.Solar Energy Heatin fooling -,
Fast Bntcr.Ditt Street ❑ Q 5.Wind Power Device
/dd-ea(Vamsr:
=dn Indiana 47 5 ID C2 6.Hydroelec5ig(�gp{. GctieINTY AUDITOR
n ZIPCnee Gibson
cn no: ❑ 7.Geothermal Energ}•Hearing/Cooling Device
h z 2.Does the buyer have a homestead in Indiana to be I property a residential rental property?
❑ 0 8.Is this P P rty?
vacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
608 EASinBdiRS��°� •- S`?' below.Please see instructions for more information.
Address(,Somber and Sate')
Not available in all counties)
nra:Ntcvr t7F )N 47665 TIARA L. CROFILEY
c,.'.5:a.ZIP cad[
Councy
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