Homestead_Martin (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER •
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Preparer of the Sales Disclosure Form rTitle // Las
q((q�,�(ddress(Number and Street) Co,hpany
I t•• f�C.L% ,A 1-,J Liel n o 3i 2 - �o ( • tt o '1 LI
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S), -
do 011R Lv/K 10)))'150/!
Seller I-Name asapea ts'an conv a ocumen Seller 2-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
pl(Z/eftdh, ly) 1/7690
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and c4plplete as requ• by aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
—
Man oofSeller 1 Signature of Seller
Janile Lyis. !o(ci4 '15on (oft9 /I to
Panted Name of Seller Sign Date(MM/DD/YYYY1 Printed Name ofSeller •to(MM/DD/YYYM
F.BUYER S) GRANTEE S -APPLICATION FOR PROPERTY TAX-DEDUCTIONS-IDENTIFY ALLFMLTIIIATJA I,Y I r"
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yet I-Name as appears on conveyance (acru�ment Buyer 2-Name as appears on conveyance Sbd'hi[en20 2016
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Addres(Number a Street) Address(Number and Street)
THE SALES ISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO • CONDITION YES ON
❑- -1.Will this property be the buyer's primary ❑ mesteaa.
residence? Provide complete address of primary olar Energy Heating/Cooling System
residence,including county: ❑
( 5.Wind Power Device
Address(Number and Street) - ❑ Ia% ydroelectric Power Device
❑ e thermal Energy Heating/Cooling Device
City,State 21 a County
❑ 2.Does the buyer have a homestead in Indiana to be El 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.
. •, •• • Ina -,t ,- .
Address(Number and Street)
a4. -04-- b ?- - 000 ... 2-81-O/2
City,State ZIP Code County
. Primary property owner contact name E-mail