Homestead_Bottomsw�;
Dana I�ACE;ide
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60fi 61ain Street
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Jasoer IN e)546
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closer I
nn< IThe Title Co.
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Seller2-Nnnien;nypenrtonranvryanrcdoamen[ I
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Under penal[ies of perjury, I hereby certify tliat tl�isSalcs Disdosure, to [he best of my knowledgc and belief,
and comp e as I��qpired by law, and is prepared in accordance witli IC 641-5.5, "Real Property Sales Disde
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rnurcx����.otct��-rte��ji-:A1'P.CICA'1'ION.FOR�PROPERTY TAXd
Gene A Bofloms Jr
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SiynnNreo(Seller
Nnme o: appmrz on
TIIH SALES DISCLOSURE FORhI A:N' BE OSF.D TO API'LY FON CENTAIN DEDUCf10%5 FOR TIIIS PROPHRTY. IDE��TIFY ALL OF THOSE TIIdT
YES NO [O\DITION
�❑ 1. Will [his property be tlie buyer's primary
residence? Providecompleteaddressofprimary
residence, induding county:
Add , � � . �,)
`lil� � � 'i bson
Ciry.Smtel/Ptode Counry
❑ �2. Does the buyer have a homestead in Indiana to be
vacated (or chis residence? Ifyes, provide
complete address of residence being vaca[ed,
indudingcounty:
V't3
Q�
0
❑
❑
❑ 3. Homestcad
� 4. Solar Energy Hcating/Cooling Sys'�
� S. Wind Pb�ver Device
dG. Hydroelectric Power Device
,�—,/7. Geothermal Energy Hcating/Cooli
�y/ 8. Is this property a residential ren[a
[� 9. Would you like to receive tax sta[e
property via e-mail? (Provide contc
below. Please see instructians%r m
Not availoble in nll rounties.)
�e, correct
A[[".
�G��T
oR � �
Device
�nCS for [his
in%rmation
� information.
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[iry.SmmZP � faunry
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Under penalties of oerjwy, I hereby certify that this Sales Disdosure, to the bes[ of my knowfedge and belie(, is truc, correct
and compiete as required by law, and is prepared in accordance witl� IC 64..1-S.S, "Real Property Sales Disdosure Act". (Note:
Spouse information. Social Security and Driver's License/Other numbers are no[ necessan� if no Homestead Deduction is
�bein fi d.) / / �+ ^�
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License/lD/O[herNumber Number Lirense/I�/Other'Number