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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Preparer of DisclosureF r Title
Address(Number and Street) Company
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City,State,and ZIP Code Telephone Number E mad
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Seller l-N�a a•s appears on congeyance document Seller2-Nome asannean on conveyance document
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Address(Number and Street) Address(Number and Stre f
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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 4o pletp, s required by law,a u.' s 9repared in accordance wi IC 6-1.1 .3 "Real Property Sales Disclosure Act".
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Printed Name of Seller Sian i•te(s..e/OD/YriYI Printed Name o(Seller S•n Da.e(A.N/DO/Yrip
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aF?BUYER[5)(GRANTEE(S)=APP.L[CATION,FOR PROPERTY TAXpEDUCTIOIJS='IDENTIF�aAGL`ITEMS THAT AP,P,LY? s _L
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Buyer 1-A' m as appears op conveyance document :uyer2- amep appea rs on conveyance document
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ddress(Number and stree cYdress(Number and Sal
YES NO CONDITION
th I 1'ES NO CONome\ JSO/tr4, V
gl ❑ 1.4Vill this property be[he buyer's primary ® ❑ 3.Homestead '�`//j/T
residence? Provide complete address of primary n ® 4.Solar Energy Heating/Cooling Sysi$a
resideu�in uding county: , 4,,
q/p V /�tt 3/i /�/,v(,f'OtJ( /t' -?7d, /a ❑ ®- 5.NindPowerDevice ,9
Address(Number and Street) ./ / / n ® 6.Hydroelectric Power Device •
g/5 I ❑ ® 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County FF��11
❑ tpp�II 8.Is this property a residential rental property?
❑ ® 2.Does the buyer have a homestead in Indiana to b
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.
�s �) Not available in all counties.)
Address(Number and Street) n/-/ /Q .52 "" 2 3
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City,State ZIP Code County /A A
Primary•property owner contact name E-mail'/ `'