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ANA SALES DISCLOSURE�FOY_F, -y
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WyREPARER /,
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1 la Dudavure Form i ComPanY , CD .
Preparero the SOUS / #1`
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Address(Number and Street) ; ( / m"� )! - _ '.'�
and ZAP Code - K- �. a' i 1 / c
My.state, , a • . R
GRANTOR S- - S e l l e r Nome as appears on conveyance document
+E SELLERS e -(.i 'Gt
/11 f- tai a - 71 -rsan conveyance dneum lit 3. r
Seller)-Name as _ I - -
�/P S /Of Addrea(NumberondS' t) T.1/ L/
Address(Number and Street)
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Tele• one Number Ct
Telephone Number knowledge and belief,i5 title.COTTe t this Sales u [hereby certi eth red n accordance Disclosure,IC 6 i best Re 1 RfQoperty Sales Disclosure Act".
Under penalties ofperj perjury,
and complete as required by law,/d is prepare I` !L - -
As / t_/rte " Cs@ilitri_d/ '7 ,e /_ - c li-/e?
CLg"ary re niSen " -s Si n Date NN D -
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Pon Name• Seller
,F.BUYER S ___G S .='APPI:ICATIOt v'FORPROPearv�rnx,DSDUCT:ON�e�i���ALL I����TARPLY� ��a-i
/ /� ULL conveyance document
• Buyer2-Name as aP o /, ,zd. -s 7
Buyer I-Name as appears m conveyance document � �d `•
s, Si. a ` t d
Address umber and Street) Q
Address(Num rand Street) ���/_b �e , -� L , y
O�}L-!/!il/1�` ! fy , �� V
Tele•hone Number
Tele•hone Number
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
IYDI1[ON
• '' 'YTS .0 CONDn10N
r ❑ 1.Will this property be the buyer's primary , n '( • . . '
residence? Provide complete address of prima a r- ¢molar Energy Heating/Cooling System
residence,including county, ❑ ,L—vS, 5 nd Power Device
A'SsNumber nd ` r Zd s% ❑ 6 roelectric Power Device
6)/T (Number l i -7 V Delay
�jy�
�� �, eothermal Energy Hearing/Cooling Device
City.State ZIP Cad I afla el ❑ Is property a residential rental property?
/ , ry
❑ 2.Does the buyer have ho yilin ndiana to be ❑ q Would you like to receive tax statements for this
complete for this s of a side1 beinTh e
complete address of resid bt�i ed, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
^n/ Not available in.all counties.) ��.��yy�
•Address(Number and Street) I i- • -1/'^7Pr ..5.+•-c_ /13/^)a'']�'� '4 Coo 31 o-c t
t;IRSON COUNTY AUDITOR M (NeJf/Ac °
Coy,State ZIP Code County
Primary property owner contact name E-mail