HomeMy WebLinkAboutHomestead_Childers INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Preparer of the Sales Disclosure Form Title
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City,State and ZIP Code 'Telephone Number E-mail
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Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
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�Adndress(Number and Strevect.� Address(Number and Street)
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an, oDmplete_a�s required by law,and iis�prepared in accordance with IC 6-1.1-5.5,"Real Pees Disclosure Act".
gnature fSeller l) S n reo Seller
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Printed Name of Seller I Sign Date(MM/DD/YYYY) Printed Name of Seller Stan Date(MM/ab/YYYY)
MBUYER(S)T/,GR'ANRWE t-jAU L'ICATIONI$QRIP,ROR ERTeYI+DA;Y}DED,UGTIONSLAQENIRFeY(MIL TEMSO ATMila1?Y1- _ -. I
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BuyerI-Name as appears on tunveyan document Buyer 2-Name as appears on_conveyance season
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A ress(Number and Street) T Address(Number and Street)
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRgEdija IDENTIFY ALL OF THOSE THAT APPLY.
I YES NO CONDITION AYES NO CONDITION
[ir ❑ 1.Will this property be the buyer's primary ( - Ilk-v❑ 3.Homestead
residence? Provide complete address of primary ❑ Q/q..Sb1a 1nergy Heating/Cooling System
residence,including county:
9„f32 r. /77/77;‘, $—1 ❑ u
5.Wind Power Device
resr A'umn ndStreey-j� - 5,7� ❑ E3" 6.Hydroelectric Power Device
/,/ •C 7 /4SU", ❑ az 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑-'2.Does the b e a E-- in Indiana to be ❑ Is this property a residential rental propem
vacated f i e den I I.rovide ❑ Would you like to receive tax statements for this
complete r s fro c` . ng vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
MAY 11 7017 Not available in all counties.)
Address(Number and Street) a(6--610-6(_7 O3-0%O3 q-OOa-
City-State ZIP Code County ice,,
', „ it Primary property owner contact name E-mail