Homestead_Curl (2)DISCLOSURE FORi�I SDF ID:
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Preparerof Ne Sales Diulosure Form
803 E State Hwv 68
Addres (b'um6er and Svret)
HaubstadtlN 47639
Ciq�. Stua, and ZIP Codr
�rianna Snindler
Seller 1- ��'ame as appears on convqance dxumen[
dddress (A'um6er and Stree[J
�-1a��6stadt W C7639
CiY. 5rnh, and ZIP Code
Title
iaubs�adt Stab
Company
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Seller? -;:ome as appears an ronve}vnce darument
Addrers (h'umher and Street)
Ci.ry, Sm:e, and ZlP Code
Under penalties of perjury, 1 hereby cer[ify that [his Sales Disdosure, to the best of my kno�vledee and belief,
and comple[e as required by law, and is prepared in accordance �vi[ �IC 64.1T,5,.$, "Real Property Sales Discic
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SignaNreo(Seller � 3 SignaNreo�Seller
BriannaSnindler 72/049?n15 Er�'Curl
Brianna Cud
Bu}'er 1- A'amr as oppears an ronvry�onre document
Address (Kumbrr and Svee[J
HaubstadtlN 47639
Ciry, Sm�e, andZlPCode
Buyer? - l:ame
Address (Num6er and StreetJ
Ci.ry•. Smte, and ZIP Code
TIIE SdLFS DISCLOSURE FONM AIA1' BE USE� TO APPL1' FOR CERTdIN DEOORIORS FOft TIIIS PROPERTI'. IDERTIFY ALL
0 ❑ 1. �1'ill this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
address (NUmber and Sveet)
Haubstadi. �N 47639 Gibson
Ciry•.SmceZfPCode Counry.
❑ Q 2. Does the buyer have a homestead in Indi2na to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addras(NUmberandSVeeQ
Ciry. Swte
Counry
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3. Homesread ' q(��
4. Solar Hnerey Heating/Cooling Sy�
5. ll�ind Power Device
6. Flydroelecn-ic Po���er Device
7. Geodiermal Bnergy Heating/Cool
8. Is this properiy a residen[ial rent
9. lVould you lihe m receive ta� s.at
proper[y via e-mail? (Provide cam
belo�v. Please see instruc[ions(or n
Abc availa6le in all counties.)
� rnrnaryproperryowne�ronmarrmne
Under penalties of perjury, 1 hereby certify [ha[ Ihis Sales Disclosure, to the best of my knou•ledge and belief,
and complete as required by law, and is prepared in accordanm wi[h IC 6-11-5.5, "Real Property Sales Disdc
Spouse informa[ion, Social Security and Driver's License/Other numbers are �[ necessary if no Homestead I
b�e(�ing f led.]
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SignamreoJBuyer] wj � SignamreofBuyer?/Spouse
Rr'ann� ('� rl 19/�7015 �r'4 ('nrl
Pnn:edLegaLYamea/Buyerl SignDace(HY/OO/YYrY� PnnredLegalA'ameo(Bvy�er2/Spause
LastSdigiCCOfBuyer7Driver's Smte Las[SDigiuo(SocialSecurityNvm6er Las.>digitsa�Bu}•er?/SpouseDriver's Sm[e LaseS!
Litense/lD/OtherNumber Number License/ID/OtherA'umbe�
E.mail
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property?
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