Homestead_Phillips (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D P,REPARER l r. '_tW41yx?a is± itZtil. 'OLLWaa' . - '•.r .' wr_-.s�3 •°r a%%-.
,.�_-._3 � sue; Y .sl'��_ `1'�"�-. 7- �h^�'�Si�`�'� :-a�:"�'s
Lob in eek f *esker
Preparer of the Sales Disclosure Fo Tide n
762 _ S. �Af'x 5T- Sell #Pipe A'feeks /�pyffK
Address(Number and Street) Company
f'R%NGr -fog) ) _�i r i 417&,74) /-9/2 -39¢ 7 7 7
City,State,and ZIP Code Telephone Number E-mail
fE?SELLER(S)%GRANTOR(Slat-^144S-,.'Y- 'uWrat ..y:+._..c--. '.^_ 4c..:;e:.-_ ls.'- _i-"..v. *r,-x.Er_en:ti.l C„b`., z"�•' tn•i
7;Ana,44 4• wA-finer 6-Ainsl,vd4 .7: u/,9//a.cr
Seller I-Name as°pikers on conveyance document Seller 2-Name as a rs on conveyance ey.nce docomen[
334. 1 S . ST. Rd 5-7 J3'/ 5. 57; ,ed _57
Addr (Number and Street) i� Address( umber and Street)
vakratick,' - 2 Cnk1ANd°
_
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and com l(ete as required by law,and is prepared in accordance with IC 6-1. 5.5,"Real Pr9Perty S//a��les Disc 're Act".
Si ..area fer S(gna re of Se er UUU
A:079ll 7 . ,tl�>.c mo rla.Vlc&a Sr - [lae.P_
Printed Name of Seller/ Sian Date(MM/BB/YYYY) Printed Name of Seller Sian Date(.MM/DDIMT)
F:IBUYER S ,"_-••'.' t - ON FOR:PROPERTY;TAX DEDUCTIONS2 IDENTIFY.ALL,ITEMS-THAT.APPLY 1,a i>J :'t ,t ` -
1aet e e Phi/uipi ctnz (e -tin J PA i IL'Ps
sayer - •a ,, ,nv. mce docu,. Buyer 2-Name as appears on conveyance document
/02 GAest,vv -St• /oz Ches(,aot Si •
Add resqUgmber and Street) Address(Number and Street)
PffNc15ca ..-.1- `/7A4'?
(r -9 / I cisto/ 2?) '17(-5'9
YES CONDITION I 4Bfri0,1' MAR 18 2016
❑ 1.Will this property be the buyer's primary \ u u ° omestead
residence? Provide complete address of primary ❑ oar Energy Heating/C
residence,including county:
D .Wind Power DeadasoN COUNTY AUDIT
Address(Number and Street) ❑ � ydroelectric Power Device
❑ J-Ceo ermal Energy Heating/Cooling Dev
City,State Z,/IPy�^ a County ��LLL((� III///
❑ L7 2.Does the buyer have a homestead in Indiana to be ❑ s this property a residential rental property?
vacated for this residence? If yes,provide ❑ 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.
Not available in all counties.)
Address(Number and Street) g'‘ - /3- 12 /aor . oat. cZ a b -co _
/st l Q/j� // S 9 Zr 4691- g /iJ
City,State ZIP Code County
Primary property owner contact name E-mail