Homestead_Bichler INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Prep 11%2 e Sales Dls neFer14 I Title
Address(Number++ber and Street) Company
Company
50o1 sL - /i/ICoki S
ay,Stoke,and ZIP Code / Telephone Number E-mail
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:-aSEEL•E )/GRANTOR(SI ial .a`<=53' iMP .017:-'-.'W . af'_sritiat-iri-: �vS rn.-` 't+� .,7 .�2
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Seller I-Name as a pears on conveyance document Seller 2-Name as appea on conveyance documen)
SU O I S &/') aLo&-5 r lj 9 0 / s. L. ! ,(. -(0 ) 5 /-
Addn. Number and Street) ,� / Add Numbers and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature ofSelly
Rex A. c)A/e&L //-3-/4 P/3 Ns t/ E, O 'N crJ l/ -J- / 4
.-..Printed Name of Seller Sian Date(xx/DD/YYYY) Printed Name ofSkIer Sian Date(xx/DD/Ym)
F BUYER(S)%GRTANTEI '_'-AP,P,L•ICATIION'F,ORPROPERTYisTAX;DEDUCTIONS?`IDENTIF,Y,'ALL}ITEMSTHAT,'AP,PLY -r�'3 "^ - wa
Ia , r 1, I _e (�CJ/3-1 Jd/i /'I!' A Le /
Buyer 1-Name as appears on conveyance document Buyer 2-Name ass pears on conveyance docume9t
52'/05 :�jeoNJST 07/05 / /c1LQ_okJ sr
A (Nu/myber9n/d Street)�f�n7 'I /(/ (�` \f // /) A/�/�p/ rfblumbera d Street) ,mot \n/ / �7/ /
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. q e
YES NO CONDITION Er NO CONDITION OV'1 O 2016
01 ❑ 1.Will this property be the buyer's primary / I k/I I I 3.Homestead
residence? Provide complete address of primary ❑ Q 4.Solar Energy Hea tem
residence,including county:
❑ 2' S.Wind PowSlWattYN COUNTY AUDITOR
Address(Number and Street) ❑ (2 6.Hydroelectric Power Device
City,State ZIP Code AL County ❑ ram 7.Geothermal Energy Heati•g/'..ling Device
❑ 2.Does the buyer have a hom a ndiana to be ❑ [' 8.Is this property a resid:''� 14 ,-ntal property?
vacated for thiss,44e ce? If yes,provide ❑ El 9.Would you like to re,: . ax statements for this
complete address or r/sideaMbeing vacated, property via e-m.:l? 'rovide contact information
including county below.Please see in ructions for more information.
.7iJ/ Not available in all counties.)
Address(Number and Stree[y 188ON COUNTY AUDITOR ao - -a 0-f �o t
City,State ZIP Code County
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Primary property owner contact name E-mall