Homestead_Yang . INDIANA SALES DISCLOSURE FORM SDF ID: • Page 2
ROefiEEARER : _ s s ', *r 4-•::5•_ -d3-.,e-z: -•;1.0---€ ? gt: ::ca:_:.;.r4or>5.s.M .::_dial itr 2,-;:t. :;11
KIM SPAHR MANAGER
Preparer of the Sales Disclosure Form Title
505 E.WASHINGTON BLVD;P.O. BOX 11647 LANDQUEST TITLE GROUP, LLC
Address(Number and Street) Company
FORT WAYNE, IN 46859-1647 260-469-3948
City,State,and ZIP Code Telephone Number E-mail
lE'•$ELLEk(S %GRANTOR(8riV i wl`kE N ? { iaral v «:IMA 9 Si,
U.S.Bank Tmsl N A as Trustee
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1701 Regent '
Address(Number and Street) Address(Number and Street)
Irving TX 75061
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
nd comple'as req . ed by law, .n 1 is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
.. o t l`
gnature of Seller Paula Kelley soots ofSeller
Rank Trust N.A. as Trustee Dy� �.S� IS
Pri red Name of Seller Shin D a(MM D/YYY) Printed Name ofSeller Sign Date(M01/OD/VY1)1
(IF3BUI�R(S)7f,Rt1NTEE(5)rAP,PL'iCAT10N FOR.RROP:ERTYyPAXDEDUCTtONS a1DRNT1EYsAL'a ,AR2 �,ti'
a n Phoua Yana
uncut n cut ap�rs on conveyance donlmea[ Buyer 2-Name as appears on conveyance documen
liitfer 5 _/ JUN 9
IAd ess(NUn roznareet) I �� bqc Address(Number and Street) Mb
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION CONDITION--
❑ 1.Will this property be the buyer's primary ❑ 3.Homes ..
residence? Provide complete address of primary . 0 4.Solar Energy Heating/Cooling System
�1 rl�sidenc cluding county: ❑DO kti 5.Wind Power Device
Lenin f ss( ember and Street)1 � is-12 (art f ❑ IN 6.Hydroelectric Power Device
` CIrySm[ellPCade t ( )V County
❑ 0 7.Geothermal Energy Heating/Cooling Device
❑ N. 2.Does the buyer have a homestead in Indiana to be ❑ ❑ 8.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: low.Pleu3e see In • -• ormation.
Not available in all counties.)
Address(Number and Street)
,Z (o -/5- .2S-too - 0 02 . O.IS-0A5
City,Stare ZIP Code County
Pma • , ,. .... E-mail