HomeMy WebLinkAboutHomestead_Black (2) INDIANA SALES DISCLOSURE
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'D PREPARER sY2S> x .-±...�_ZF.0 at4/ Ge„ .-' , x -
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Preparer of the Sales Disclosure form Title
702 S maw ) St- /17e«s• Ec�d,
ddress(Number and Street) Corn ny
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City,Statg and Zl Code Telephone Number E-mail
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nEiSELLER($`.GRANTOR($]sicti" "--=-*�'-ale Zit- -a `�'
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Seller 1-Name as appears on conveyance document
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SRa` 5- 300 Seller 2-Name as appears an conveyance document
ddress(Number and Street) Address(Number and Street)
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and plete as required b . is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
,25.0,re of Seller Signature of Seller
Jo$lti/A 4 meeA S
Printed Name ofSeller Sian Date(MM/OD/YYYY) Printed Name of Seller
Sign Date(MM/DDmrt)
aFaBUYY .• i' c,+ ;j._ • •,•,: •TION:FOR,PROP.ERT.Y:TAXDEDUCTIONS--'IDENTIFY ALL:ITEMS!T��HA•T-APPLY_a;ti tiiIiuL
—BuyerI-Name as appears on conveyance dory Buyer Name as a
/.2 / '/J/ of r{� 51 ye /�Ppears amm�vryance document
Address(Number and Street) T Address(Number and Street)
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PrI.
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION , •ES NO C.. . ,_ •_rni -.ei
cg, ❑ 1.Will this property be the buyer's primary gi, ❑ 3.Homestead GIBSON COUNTY AU e, : OR
residence? Provide complete address of prima II iii. - o ar nergy Heating/Cooling Syste
residence,including county: q
/a! Al grotty-rite SI-- Pe- 4 G+ -.Q I/-U ❑ j 5.Wind Power Device
Address(Number and Street) 4/7&7U ❑ ®, 6.Hydroelectric Power Device
❑ igl 7.Geothermal Energy Heating/Coo ' g Device
City,State ZIP Code County p1
❑ X 2.Does the buyer have a homestead in Indiana to be ❑ 1a 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 14, 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
,o am a. • - . .. .
Address(Number and Street) (,,
City,State ZIP Code Coun a`" - - / o1 -0700 . 00O. '0 7 -0). S
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