HomeMy WebLinkAboutHomestead_Ziliak INDIANA SALES DISCLOSURE FORM SDF ID:
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aD:P.REPARER'�-r r:;~:.7n5' -i.?" 'r, s :s' t- �Yfi?'+r1- " s - s.. t ..T'G;C'v v .
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Preparer of the Sales Disclosure Form Title
Address(Number and Street) Company
City,State,and ZIP Code Telephone Number
E-mail
:E':SELLER(SVORANTOR(S) . :4ttxcX;:-- ss�..'°” ' 3.l ' 7j :._ ,,.c Wi-it=" t"c.,aaT: _+ 1s:,-.
see,I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document /
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Address(Number and Stree Address(Number and Stree
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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 y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
gilt.-- a- - •
signature of Seller . Signature of Seller
Pi A&net a C rc ./ •t 2- OC/D 7/,Zf.(S
Printed Name ofSeller Sian Date(M,M/DO/YYYY) Printed Name of Seller Sian Date IMM/aD/YY111
?F.BUYERS)\/GRANTEE(S) APPI:IOATION:F.OR'rPROPERTY__TAX:DEDUGTIONSrIDENTIEY ALL;ITEMS.THAT •PPLY�- 11,7:-._
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Bv}mrl-Nameasappears on conveyance document ( t Buyer 2-Name as appears on conveyance document •
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Udress(Number and Street) Address(Number and Street)
E. i be .- 4'a 1(1 (T,. ti7Cj3 ✓o�,
THE SALES DISCLOSURE FOR.S1 MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. Ci/N/,y/jam
YES! NO CONDITION I YES NO CONDITION •9 Uri)
iN ❑ 1.Will this property be the buyer's primary Xi ❑ 3.Homestead 1 0R
residence? Provide complete address of primary ❑ ® 4.Solar Energy Heating/Cooli Syste ei
�^ residence,including county:
e (3 9-7 S t1 So C ❑ X�( 5.Wind Power Device /(�Q
dd�(,lvumberanil Street) ❑ x! 6.Hydroelectric Power Device
S k„ n i l-i 7( 17 G , �>Sni\
f ❑ Z 7.Geothermal Energy Heating/Cooling Device
City,State Zl Code County
El 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 ❑ NI 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) / n /[�
City,State ZIP Code County 191 —g° ..0 2—/66 — C . a" e-00/
Primary property owner contact name E-mail