Homestead_Lashbrook " IYIIIIANA6ALFS DISCLOSURE FORM SDF ID: Page 2
;D?:PREPA tit R `- r r„2 o mast ,Q.z �3e-.-�.Ee'li'suX�. .. n;{e�t� t" t 'Wiz..
_ �c.::��. - �'� cam- �.
Prepare(or•^({"!��-/`�e- lJ — ` \ Title _
Address(Numberand treet) Company /I
y� L �V 117G Ia(d Star (e -i f/- -7� l �
Ciry,55tat4 and ZIPCode Telephone Number E-mail
Vo I>-- if' ) !- 'I L77 N
;E-'SELLER' S)%GRANTOR(S)aer -.f_ ?3;ri..''sra u ;? -z_ 'rum- e`G.=3 ;xS s '' r-f -"`: a gt_-
•
h 1
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
aa.) (tJOVri. �2f��
Addr (Number and Street) -D l�W' al"5 Address(Number and Street)
1'40(�
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
n c
Signature of Seller Signature of Seller
Pe.."7/7 s 7+-2 ,1 b titz(1 W 1
Printed Name of Seller• - Sign Date(1414/DD/MY) Printed Name of Seller Sian Dote(HM/DD/YIYY)
F:BUYER(S)TGRANTEE(S) APPGICATIONFOR PROPERTY TAX DEDUCTIONS IDENTiEYrAti A T >' -iN 411?
'Buyerl Name as appears on;onveyance document Buyer 2-Name as appears on conveyance document
Pfi 71 3 a 10th s fllov°'1al(`t.- APR 25 2017
Address(Nutt,. and Street) \ Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
�' ❑ 1.Will this property be the buyer's primary E ❑ 3.Homestead
residence? Provide complete address of primary ❑ ®- 4.Solar Energy Heating/Cooling System
residence,including county: ❑
S.Wind Power Device
Address(Number and Street) ❑ .9 6.Hydroelectric Power Device
City,State ZIP Code County ❑ 9 ?.Geothermal Energy Heating/Cooling Device
❑ 2.Does the buyer have a homestead in Indiana to be ❑ ❑ B.Is this property a residential rental property?
• vacated for this residence? If yes,provide
de ❑ p 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:
K,ft, Lc, sk h`,.I /-<
City,State ZIP Code County
Primary property owner contact name E-mail