Homestead_Gaines�
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INDIANA SAI.GS DISCLOSURE PORM
Ci.nny P1ul.len
SDGID:
r�.p�... o/ �n, s��o nr�d�,��.� ro.n�
J33 N. Pem�^,vlvania St. �'_.�. 510
Addr e�r (NUmh.r nnd Sb mtJ
Iiidiflnapolis. IN 46204 _
❑ly. Sintr, and]IP Cnde
eu-eCary o[ Housing and Urban Develo
fdler 1- Nnm• n� npVeme on muvq�vnce dacvmmt
0 P1�r:ietCa Sl:reet
Add�m �Num6o nnd Sbttt/
AClanl'a, G�t 3030i
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Under pe� ��I/Yes of perjury, I herehy cert;[y i!iat chis Sales Disdc�ure, [o clie best of my Icnowledge and belief, is [rue, cnr:::
�nd coin"�dyne as required by law, and is p;��oared in accordancc :si[h IC 6-1.1-S.S, "Real Property Sales Disdosure Ac[".
�JS.II.r J �(� ��
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I o Seller ' .i(a� e IIM/DO
115:'�GIi�ANTL•Is�S:r='.'APPLI.CAT[�.N-'c0'.:'DF� C�ION�'AND�.
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'l 11G SAI.F.S 1115GL115URt FORM �IAY 8 E USL� TO APPLY LGI: i E RTNN D@�IIQIONS FOR iY.: `. P ROPCIIiY. 70 EfJTIFY nLl OF THOSE nlA'r MrLT.
�� l. Will tliis property be the buye�'s primary (� I
residence? Provide completz �ddress of prim�y i
residence, induding county:
88�a s Me�dow �n1
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AAdruilNmnherandS�rmQ,�� \ _ . �1�(O�S G�b�O�
G��vc �1e , rn, -�
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L7Ly, 5[nle 7.1!' Cndc
� /� 2. Does Ihe buyer have a horescead to Ue vacated fo:
lhis residence? Ifyes, provid�c cumple[e address of�
residence vacating, indudic� county:
Addras (Mnnhernn�lltrert)
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❑
� ,3.
Heating/Cooling System
Wind Power Device
�Hydroelectric Power Device
7. Geod�ennal Guergy Heating/Cooling Device
� 8. Is lliis property a residential rental proper[y �
�G=i � �=9= -.�"� � �� i� =U�r.�
Clt •, 51o�e ZIP Code
Unde.r pen:�ICics of perjury, i hereby �erdy thaC this Sales Disdcsut'e, to tl�e best of my Icnowledgc and belief, is [�ve, �er
nnd coinplete �s��ecp�ir�d bY law, and is prepared in acrordancle with IC G-1.�-5.5, "Rea� Froperty Sales Disdosure Ac[".
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SignoNrt o/Buye2
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