Homestead_LukemanSALES
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Selfer 2- Nume af,�ypevrs on conveyvnre documer.t
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Under pe es er�ury, l hereby certify that this Sales Disclosure, [o the best of my knowledge and belief, � true, corred
and co `% e a re �red b la� prepar i acc dance �vith IC 6-1.1-5.5, "Real Property Sales Disdosure Act".
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Pnnred Name of5efler Son Da
F. BUYER 5.GRANTEE S-APPGICATIONFOR PRC
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TNE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN
�❑ 1. Wil] this property be the buyer's prim y��
residence? Provide complete address o
�7U r si nce, including c L G�
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Addy�f Nu 6eranC tree
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Ciry, State ZIP [ode [ovnty
❑ 1�2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addr¢s(Numbvand5tree[)
Ciry, Smfe ZIP lode
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Buyer2�Nameas mrsonconveyuncedocument
Addras (Numbu and Street)
Ciry, Sm[G and Z!P lode
PROPERTY. IDENT[FY ALL OF THOSE
[t� ❑ 3. Homestead
❑ [v]' 4. Solar Energy Hea ' o Cooling System
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[�' 6. Hydroelectric Power Device
[]� 7. Geotherma] Energy Heating/Cooling Device
[� 8. Is this property a residentlal rental property?
[]� 9. Would you like to receive tax statements for this
property via e-mail? (Provide conmct informotlon
below. Please see instructlons for more informadon.
Notavaila6/e in alI countles.)
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Under penaldes of perjury, t hereby certify tha[ this Sales Disclosure, [o the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Act". (No[e:
Spouse information, Soci Security and Driver's License/Other numbers are oot necessary if no Homestead Deduction is
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Lice�e/fD/Ofher Number
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LastSdigiaofBUyer2/SpouseDnve/s Sfnte Las[SDigitsafSocialSecunry
Number License/!D/OtherNUmber