HomeMy WebLinkAboutHomestead_Ellsworth •
INDIANA SALES DISCLOSURE FORM SDP ID: Page 2
I D.PREPARER
,7� Ai / ' '1 • / L o .S/,/ Jfl .,-4-//)7
Prepares r li r, J losurf Fo•C.. = Titl �- "
/P --< , 6/9(244 S� lii / / -S %5TH-` (--
C
AA , nhrr an!5 - y � ce / ) �
, / — .
C 7
C::.;Sinn and 211'Cole / Telephone Number If mail
I i____E.SELLER s)fGRANTORJSi
7 xV, �l',ci,-'lam 17 %6A cl ,F•<�//4-c/,i
Seller i-7:ame s appears on conveyan" document Seller 2-Name as appears on veyance document
/31,EZ p- // V3 'cfz'OEy-7 fir-
f'n•■t(�Xuuhernr:d�.H/cfct� A drress(Nun, cr and Street)
!7(41 /C /' %'"7776 td r Z t/d•//j VT ( C /-' �j %=�
•
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comp e as,requir' I by law,and is prepared in accordance with ] -5.5,5,"Real opertv Sales Disclosure Act".
1
*atm, : [Seller .Anna re of Seller ,. �
I
in Of(/-' �/--2�/./s2 ,7 ,,/ r ' n F S,(>2 it sir•-s e",," a 64.(/)o, )--
I Printed N,true of Seller Sinn Date DIM/DD/1'YYY Printed Nome o Seller Sian Date WHND/YYYf
F.BUYER 9/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Thaw I Nat r lm up al'un w"mnveyarue duuun.nt Buyer -Name usu ears on conv a ocu en
riddrr.,..-Nrunlv-and Y appears eY
1 l Address(Number am ' et) \
(AV g7t i/t�f-f'/• �f�A 1% � g
Tr- HE SALESPISC.LOSIIREFORMMAYREUSEDToA I'PLYFORC E.RTAI.NDEDUCTIONSFORTHISPROPERTY. IDENTIFY ALL OF'ISAIfStiVII anti NTY AUDITOR
. YES ND rosn1'I'ION I YES /TO CONDITION
j ij=1 I Will this property he the buyer's primary ❑ 3. Homestead
! residence? Provide complete address of primary
❑ R•74.Solar Energy Heating/Cooling System
iresideitce,including m
1;r7c/ A/ ,r-/F-72 /_ v ❑ DVS.Wind Power Device
.
I 'dddrr±ctnrr/be••IndStreet) j- -f ,�yy'` ��+ ❑ 6. Hydroelectric Power Device .
,(C1/4 It-fA d_�Io 'v-:1'-cat ❑ B7 7.Geothermal Energy l leating/Cooling Device
Cn;Star,LIP Cod. county
I ❑ Is this property a residential rental prupenv
1 j_I
I ucs the buyer have a hnnnstcad in Indiana lu be
I vacated for this residence? If yes,provide ❑ 9.Would you like to receive tax statements for this
Icomplete address of residence being vacated, property via e-mail?(Provide contact information
I including county: below. Please see instructions for morein(u'nmtion.
Not available in all counties.)
d:iare•,INumber and Street)
' County
r la
-103 . p? 7- —
j C:: Stm-•LIP Code
II Primary property owner contact name E-mail