Homestead_Barr INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
ID',P,REPARER" , .. ,''7 z: _ c77-1_,[jz. _
►1AA1 1111rFTii� INte & - L 141 I WNW
Pre•• �j• Sol t osur a e
1 � ,�.e ea - i1 yMr II I set vice Li(
Zcess(NUmbrand5 [J
od ��15 piny—
(.01- (q 555
City,State,and ZIP Code Cridephone
Number E-mail
la SEL'CER(St/GRANTOR(S)i •_i, .-- -- 1 _.. .. -°y :I;1, IT. ,:1 ":c --= -E .o.-
' _ I - ► LItI
lei ir; '• • •g on coneyance do.rent Seller 2-Name as appears on conveyance document
Ir If Tess(,um6erand SV
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and c eplpteq req y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Si JwFFQ////0 JJ\\W- G) Rt 1- j-
PrintedNameofSeller Sian Date(MM/DD/YYYYI Printed Name of Seller Sian Date(MM/DD/YYYYI
F1 BUYERS ' GRANTEE S I sAP,P.LICATION,FOR'.PROPERTY TAX;DEDUC IONS-IIDENTIF,,hALL ITEMStTHAT'APPLY :]
►° 1A' LI. MI tLrtf
iv, me•.appears on ca..ante dor nt a ame• appearsonronveyonc document
sB neQ 1 n 54- I � rr�� S /
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES
[�
NO CONDITION I YES NO CONDITION f
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ 4.Solar Energy Heating Ii gy
tooC r Idence,includingcounty: ������AAAAAA������
�f (f ) � J ❑ / 5.Wind Power De�ej
resc( u ¢ran street) I ❑ U✓ 6. Hydroelectric Power De�ic0/6
'�� a o (rt.
itf) U n I bs cn ❑ d 7.Geoth� ) E• -, He,ing/Cooling Device
try,State d1P Code County
❑ 2. Does the buyer have a homestead in Indiana to be ❑ �/ 8. Is this propel-4910-
rops at •;re/WI', rental property?
vacated for this residence? If yes,provide ❑ LW 9.Would you like to receive'=sp3ements 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)
alo- la-1a- 3o9- oo f .aa4 -oar
- 1 / 1 `• ..t I • ISI •
City,State ZIP Code County — —
Primary property owner contact name E-mail