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Under penalties of perjury, l hereby certify that this Sales Disclosure, to a best of my knowledge and belief, is true, correct
and c ple[e re�j' re�bJ' la���J% and is prepared in accordance with 6.1.1 -5.5 Real perry IesDisclos a Act ".
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FORTHLS PRD OF THOSETRATAPPLY.
YES NO CONDITION YES NO CONDITION
❑ 1. Will this property be the buyer's primary
® ❑ 3. Homestead
residence? Provide complete address of primar
•nergy Heating /Cooling System
residence, including county:
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❑ 5. Wind Power Device
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❑ ® 6. Hydroelectric Power Device
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❑ ® 7. Geothermal Energy Hearing /Cooling Device
❑ ® 8- Is this property a residential rental property?
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City, State ZIP lode J County
�] ❑ 2. Does the buyer have homestead in Indiana to be
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❑ ® 9. Would like to receive tax statements for this
vacated for this residence? If yes, provide
you
complete address of residence being vacated,
property via e- mail? (Provide contact information
inc din county:
below. Please see instructionsfor more information.
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Not available in all counties.)
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Address(NumpercndS
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City, Stan, ZIP Code ,wny
Primary properryotvner ronma name E -mall
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to 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 Property Sales Disclosure Act ". (Note:
Spouse ira ation, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
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