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SrJler 2- A'ame ns appears an conveyvnce dacvment
Addras (Number and Str¢e[) I
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Under penalties of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and comp�te as required byaaw, and is prepared in acwrdance with IC 6-1.1-S.S, "Real Property Sales Disclosi�re Act".
SignaNreofSeller
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TXE SALES DBCLOSURE FOFUi D1AS BE USED TO APPLY FOR CERTAIN DEDUCfI0S5 FOR
[L}' ❑ 1. Will this property be [he buyer's primary
residence? Provide comple[e address of prima
residence, including county:
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ras Numberand a�
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City, mre7JPlo1e Lounty
[!� ❑ 2. Does the buyer have a homestead in [ndiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
inc�,ding coun
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Addr�(Nu 6erand5tree[)
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Gry,SmuLP e Counry
Buyer 2- A'ame as appeors on
lity, SmtG and ZlPlode
❑ 3. Homestead
❑ [�/5. Wind Power Device
❑ [}� Hydroelectric Power Device
❑ �. Geothermal Energy Hea[ing/Co�
❑ �this property a residential rer
❑ 9. Would you like ro receive tax st�
proper[y via e-mail? (Provide co�
belo�v. Please see instructlons for
Not available in aIl coundes.)
i • � . • �! �� i
conmc[name
Under penal[ies of perjury, I hereby certify that this Sales Disclosure, to the best of my kno�vledge and belief,
and complete as required by law, and is prepared in accordance �vith IC 6-1.1-S.S, "Real Proper[y Sales Discic
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead I
being fi d.)
Sqnam �o{ryvyer] ��� SignaareoJBuyer2/Spouse
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Social5ecunryNumber LartSdigiGSO%Buyer7/SpouseDriver's Sm[e LottSL
Lirense/ID/OrherNum6er Num6er Lirense/ID/OtherNum6er
e Device
property?
nents for this
•t in�orma[ion
re informatlon.
E-mail
true, carrect
ire Act". (Note:
duction is
Date�MM/OD/YYYI')
of 5ocial Securiry