HomeMy WebLinkAboutHomestead_Schmitt (11) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
ID P,REPARERt - - -- - - — - --- - — --- —---- - -
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Prep°rer of the Sales Disclosure Form Title
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Address(Number and Street) 1 / Co non
FEZ �Z+\1�c \\ N �`' �1 , 133 04� • v ' \ _, t• n
City.State,and ZIP Code Telephone Number l
MSEIi1IER(S 7,GRAN,•T,OR(S)1 �_— 7---___ . -- ' - -----__ _ --.
Seller]-Name as appears on conveyance document s Seller 2-Name as appears on conveyance document
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Address A' mbcr and Strew • Address(Number and Street)
Under alties of perjury,I hereby certify'that this Sales Disclosure,to the best of my ku®wleIgetand1elief i rue,correct
and comp to as required by la}v,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
�ikn31j) y�`� DEC 2 S 2016
Signature of Se er Signature of Seller
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Printed Name of Seller Sion Date Dt4/DD/Ym Printed Name of Seller •--�I 'rte i. L. •t 1.4/DO/YYY1I
SF BUYER(SI GRANTEE(SJ AP.REICA`GIONtFO )PROP:E OW4TAXODEDUCTI(O�(NS IDENTIIFeYg- -. 'It II. ',. • • -A'.c[:I`__ � __
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Buyer I-Nanie as appears on conveyance document Buyer 2-Name as appears on conveyance document
702 s f_;,-«/y, Si-, 102 a L ihcol❑ 5t•
Address(Number and Street) Address(Number and Street) ' I
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDITION •
/ ❑ 1.Will this property be the buyer's primary I Er ❑ 3.Homestead
residence? Provide complete address of primary 6j ttrEnergy Heatln 7Cooling System
residence,including county: �,/
❑ L7 S.Wind Power Device
Address(Number and Street) ❑ e' 6.Hydroelectric Power Device
i
cy,smmzlPeode Co
unty ❑ 2 7.Geothermal Energy Heating/Cooling Device
❑ G 2.Does the buyer have a homestead in Indiana to he ❑ $ Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 12- 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.
Not available in all counties.)
Address(Number and Street) _ RC-lcQ-103 -oo0,29 S -oak>
City,State ZIP Code Counts•
Prima,j.-property owner con ran name E-mail