Homestead_Burton (3) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Reoina Rivard Closing Coordinator
Prewrr4elf See DUHma fa+r 77,
429 Apollo Beach Blvd. Untied Title Affiliates Inc.
Av..n,(N..ier owsm) Company
Aron Beach FL 33572 (31316494107 rriva:deussal rpm
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'-E SELLER(S1/GRANTOR(S)vni , .c ; . r ,Y , r !o-
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San:-N.ao,epa.enaa to seen aa.,e.,t Sale+t-Nor.e,.wean ea an manse aerosol
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AC..v(v,ms-cad Scree) Adorns(.r,.ber„e street)
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowle ge an e it,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'.
Sig. Sa•a-nr.4sel.. MAR 0 2 2017
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Pec::Nh'raee/See. Stn LbalwYntnrm Pn.'n Kr,.WSeer Ass
"Fr BUYER(5)/GRANTEEfS)-:APPLICATION FOR•PROPERTY TAX DEDUCTIONVIDENTIFY.ALCITEMSTHA s - "-+<"
Stanley Boron GIBSON COUNTY AUDITOR
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THE SArn Mtn net^AE FORM MAY BE CSSO TO APPLY FOR CERTAIN DEDUCTIONS FOR THii PROPERTY.IOEYa0 ALL OF THOSETHAT MILT.
11;77.5 mbomo.e I Res o cONDmos
_ ❑ I.Will this property be the buyer's primary E❑ 3 Homestead
residence? Provide complete address of primary ❑ j _,..3
lar Energy Heating/Cooling System
d.a 9Jr Seside0nce,including coumv: U L ind Power Device
f - W �// 5,�-
Aa INLva-s ore Sate) ' bs ❑ E ydroelectric Power Device
/i r' h e �v}r ,t--vt. L : c4 ..ems
C”,.rataVP.e. Co.* ❑ rrC--..��7 Geothermal Emerge Heating/Cooling Device
❑ L Z.Does the buyer have a homestead in Indiana to be ❑ ms 's property a residential rental property?
vacated for this residence? If yes,provide ❑ L 9.Would you like to receive;ax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: be/ow.Please see instructions for more infam,a:ion.
No:oval/able in ell counties)
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