Homestead_Lamb (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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C . le. A/ • /'«- Cc a s/--C /j--77-7,e-,vv
Prevarer of the Sales Disclosure Form Title ) 7
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Addres „umber and 5N-et) — Com n
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City,State and ZIP Code Telephone Number E-mail
FE?}SELL' s)yGR'[1t\trTioR(s))' —:I_ r 4_1 _ _ - 1.:_.y.
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74-1-i•� 4-. /.'��• or.�/y//a,✓ /5‘/9-"7.0X -277/i/r crc at-A-7,9-et-,
Seller l-Name as appears oqq ca eyance document Seller 2-Name as appears on cgnvey nce document
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ciaress(Numbe and Street) �_ Add s(NumberyndSreet)
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Under penalties of perjury, I hereby certify tha •'- -ales-Disclosure,to the best of my knowledge and belief,is true,correct
and complete asr (hired : • - ,and i : •pared in accordance wit C 6-1.1-5.5,"Real Property Sales Disclosure Act".
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re of Seller Signature of Seller
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Printed Name of Seller Sign Date(HH/DD/YYYI) Printed Name of Seller S(an Date(HH/DD/YYYf)
PF•?1BTUIRER(S)77GRANIPEEWIs2AP,ELI/6A�T4IO�NIF,QRPROPIERTtYhTAXi DED,UGTIONSo+IDENIT IFeYMISfi�TEMSiEWAVi'�ARP,LY(L• - - ' J
Buyer I-Name as appears on conveyance document ..- Buyer 2-Name as ap on conveyance document
370 y 577/A-a a WA/ /2
Adj s(Number and Street) '/ Address(Number and Street)
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SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THO ',gA
YES NO CONDITION I YES NO CONDITION Yee ED
It✓ ❑ 1.Will this property be the buyer's primary 12----❑ 3.Homestead
residence? Provide complete address of primary ❑ R"4.Solar Energy
R---- Heat�U CLL olinSr
tem
rest e,includin 5county:
So J /V- g.T T ❑ 5.
Wind Power Device
s-aress(Nuyer and Street) ❑ Ei---- 6.Hydroelectric Po r Devi
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City,State ZIP Code ❑ �? Geother al Ene ling Device
county roMy( P COt I Y4 j
❑ ".Does the buyer have a homestead in Indiana to be ❑ ��8 Is this property a resld��t�a � erty?
vacated for this residence? If yes,provide ❑ L'( y•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) I-/(�] /(//�//��
City,State ZIP Code County "' - "� �D� -�' ��� �'G.i
Primary property owner contact