HomeMy WebLinkAboutHomestead_FriedCiry, Smtq ond LPCade
appm.�son
[iry, Smt4
FORM
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J;Ib6r I Sepel2-Nameasay�earsanronveyvnredocvment
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Addrets (NUmber and SL-eetJ '
ligt Smte, and LP lode
'E�mail � TeleOhoneNum6er E-mail
Under penal[ies of perjury, I hereby certify tha[ [his Sales Disdosure, [o the best of my knowledge and helief, is true, correct
an��mp ete a�quire� and is prepared in accordance �tiRth IC 6-1.1-S.S� "Real Property Sales Disclosure Act".
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S�namreof5elle�— / SignaNrcofSeller
w;/1.�,� �T. r: � �f /�-/�G'"�
SmtG and LP lode
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Evys 2- Nome as appeors on conveyance docvment
� � I Address(,VUmberand
Ci9; SmtG md LP Code
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIS DEDURIONS FOR THIS PROPERTY. IOE\TIFY ALL OF THOSE THAT APPLY.
[� ❑ 1. N'ill this property be the buyer's primary
residence? Provide complete address of primary
r idence,indudingmunty:
n�'I�1 �n� 4 � �
drets(Numbera d5neetJ i
�1g� v� �lv t� N��(a5 C��,SD ✓1
Ciry, Sta[e LP lode Counry
�0 2. Does the buyer have a homestead in [ndiana [o be
vacated for this residence? [f yes, provide
complete address of residence being vatated,
induding counry:
�215 �rJ��!/1/t-i��N�' ��
Addrm'(Number ndStreet) ��
� �,Q�/��: �, � �J �f°�i12_ ��r�`.so�
Gry,Smte PCode - Counry
❑ 3. Homestead
I_l �0-' 4. Solar Energy Heating/Cooling Sysiem
� (� 5. Wind Power Device _
❑ [� 6. Hydroelectric Power Device
❑ [�/ 7. Geothermal Ene: gy Heafing/Cooling Device
❑ �: Is this property a residenrial rental property?
❑ �. Would you like to receive tax sta[emen[s for [his
property via e-mail? (Provide contoc[ informa[ion
6elow. Please see instrucdans far more informadon.
Not available in a/1 counties.)
�o b,�r f E �r� � nl,q
conrnaname
E-moil
Under penalties of perjury, I hereby certify [hat [his Sales Disdosure, to the bes[ of my knowledge and belief, is trve, correct
and complete as required by law, and is prepared in accordance with [C 6-1.1-5.5, 'Real Property Sales Disclosure Act". (Note:
Spouse informatlon, Sorial Security and�D ver's License/O[her numbe/rs are n necej sa if no Homestead Dedpuction is
being fi//� �/ S' � . � : .. ' �C� '/� Q/^��%� ^QQ�. �4 -- l%�
� Signamre o/Buyer2/Spouse
� �/�i"( /�
P. inte7lpol Name o/BUyer 2/Spouse
Sign Date (NM/n0/vYf')')
ityNum6er I Las[SdigiGSO(Buyer2/SpauseDnver's State LattSDigiao(SocialSecunry
License/fD/OffierNumber �. YumSer Lirerue/1D/OrherNum6er