HomeMy WebLinkAboutHomestead_AskrenINDIAhA SALES DISCLOSURE FORM SDF ID: Pa e 2
:.'r��arv�• ticcc�w
3D: P.REP,ARER' -�k�r�`� vs- ��-a.ck ��' ;���'���?�� > =,�.`.'�:5�.�.�t�.��m ;"�:r�?n.°i-T'.c?.6�'��'���'���'f'�"-w��F.
Prepnre� o(rhe Sola D'uclorvre Form fqe
G e.o � R. i�s K r��� �R�i � x�l
Addrw(NUm�ndStreet) Company
�f�'�f w� G s(-�Y S� JJo N�
[iry, 5:a[G and7JPCode
Y�� �r . �� / / TelephoneA'um6er E-mail
�: �{�
�. � -,� ' , ' .' , �'�
?E::SE[iliER S ,GRANTOR S ��"'��::.�5• �``�.'�,t=.,ir�+? ��_ ",-�+K ` ?�;: r. ' �+:-.?�,��q�.�
_r.:a . - `,^i'� i' �`i^a :.�i ,t�- .� ^✓ti"'�tmlt:.Y��'r`"r.
. c�N' < `n�vav=;�.Z. ;
Sel7eri-Nameasappearsonconveyvncedocument Seller2-,VOmeasa eursonronv
� C', ,l) ' �\ 4 / PG ry�ncedxummt
Addres (A'umberand Street) AOdres (Numberand Street)
(� q� c � �\ �. �.� �7
Ciry,Srure.andlJPCode �� /� Ciry,Smre,andZlPCOde
� ` � �-
Tele honeNumber E�mail Tele hmeNumber E-mail
Under penalties of perjury, I hereby certi(y that this Sales Disclosure, to the best of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Proper[y Sales Disclosure Act".
����� �� ��
SignaN�eo Iler °
Signotureo/Sefler
� ` n SG f7 q z.. Lo S�
�Pn'nwLNameo Seller SlanDoL¢(M.NNO/YYYY) Printedh'amea Seller
SIOO DOf¢ (MM D
iF:?BUYER S'.GRA�'TEE S'�RPPLICa1TI0N FORTPROPERT:YrTAX�DEDUCTIONS�;IDENTIEY.AtiL;ITEhiS;TH'ATAP,P,L-Y�� '° '-Y' ;=-'K
(� �ocq z, R, l� s k�-e .r.!
Bvyvl]'-/Narri ¢snppmrsomm�veyvncedoaument Bu rl�Nomeasa
7G � �J � � s��rC- sf : ye PF�rsomm�veyvncedocummt
Addr� (h'um6erand Svren) Addrers (Num6erond SnceQ
f'�-1-� K.ra Z..> >:� 7�; L: Cv
Ciry,Sm;
E'-mail TelenhoneNUm6er E-mail
THESdLFSDISCLQSUREFOR.NMAYBEU5E0TOAPPLYFORCERTAISDEDUCfIO\SFORTHISPROP . M1TIFYALLOF MOSETNATAPPLY.
YES 50 CO�DRIOA ES RO CO\DRIOA
� ❑ 1. Will this property be the buyer's primary �I 3. Homestead �
residence? Provide complete address of prima , rgy ea[mg/CooLng System
residence, including county: � � S. Wind Power Device
ac�</ b �} �/� S;-r��'
nl�qs�rvpmaa �dso-�p � i 1 � � 6. Hydroelectric Power Device
P ro i•� � j�/� a�%%(� �� �� � c iv � � 7, Geothermal Energy Heatin Cooling Device
City,Sm[eZIPCode Covnry � ���
❑ � 2. Does the buyer have a homestead in Indiana to be � � 8� �s [his p res ti re tal property?
vacated for this residence? If yes, provide ❑ � 9. Woul ou tementr for this
complete address of residence being vaca[ed, property via e-mail? (Provide contoct information
induding county: below. Plea��ee 1$,s�u�e�ijs for more informatlan.
Not availa6le in a(1 coundesJ �
AAdrer (h'umber and Street) /�
City.SmteLPCode Covnry ��C �.
Pnmarypropertyown¢rm r7dlrM` ��T�(-mnil
Under penaRies of perjury, I hereby certify tha[ this Sales Disdosure, 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 Disdosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.)
�� R , �-Kr�,-,
5{gnamreo(Buyerl Signa[ureof6uyer2/Spouse
C�e�rye R; A���.EN ra-y-Z��S
Printed Legal N e o/Buyer 1 Sl9n Date (HM/OD/YYY1� Pn'nted Legul Nvme ofBuyer I/Spouse 5(tJ� Dat¢ (M.N/OD/YtYY)
�-,
LastSdigiCCO�Buyer2/SpauseDnver's Sm[e Las[SDigiGSO�Social5ecurity
License/1D/OtherNUmber Number Lireue//D/OtherNum6er