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Homestead_Kihn INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Preparer of the Sales Disclosure Form Title
&OLP 11/1 a/n SI--- Pa/90KS Cowl-hi frIe (fit,, IILI"•
Address(Number and Street) Company �
Ja.Spt:—, 114 4-73y1v a1��-4 S'�-I(oq�.v
City,State,and ZIP Code Telephone Number E-mail
E.SEGCERjS)7GRANTUR(S)�-•-- -=.. '!: - -
Seller I-Name as appea s on conveyance document Seller 2-Name as appears on conveyance document
8701 w • tzet y Rd -
Address(Number and Street) Address(Number and Street)
01116 haI Al E ( 20cl
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".
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Signature of Seller t . * "SW r • ,�� 4, , Signature of Seller
Chet-i4i Rau.° L ,Sl. 4z1 lk -k
Printed Name (Seller Sian Date IMM/OD/1YYll Printed Name of Seller Sian Date(IIM/DD/tllll
_E..BUYER(SIL GRANTEE(S)LAPPLIGATIONI O-R,PROPERTYTAX,DEDUCTIONS-IDENTIFY,ALL.ITEMSWATAR Y 7 -_ ___-
LCtL Ise kihn 41 She,% 10 in
B ver_I-Name as y arc on conveyance documen Buyer as appears on conveyance document
Str �r F �LED
Add ass(Number and Street) //II _ Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TH/tgAPPLY.
YES NO CONDITION I YES NO CONDITION YMlkt
GIBSON COUNTY AUDITOR
® ❑ 1.Will this property be the buyer's primary g ❑ 3. Homestead
residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System
residence,including county: ❑ S.Wind Power Device
735 E. El enbocc.e,- L -
Address(Number and Street J / ❑ 6. Hydroelectric Power Device
1-14,11 Pseirl I- ,Street) , ,,7.70 311 (.2,b_SCYl. ❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ Gi 2.Does the buyer have a homestead in Indiana to be ❑I 8.Is this property a residential rental property?
vacated for this residence? If yes,provide l I 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.
Not available in all counties.)
Address(Number and Street)
310-1 q — 3a- 1 o 1 moo- 9/5-0d 9
City,State ZIP Code County
Primary property owner contact name E-mail