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_INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Prepare,ofrh Sales 1:4-1.Disclosure Form Title
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Address(Number and Street) Company
"P-nnUfa-Ill IN 47670 S1z-385-(n49g 51WuychvisfmaWa -luxll(+'
City,State,and ZIP Code Telephone Number E-mail•[-ETSSL a(S)7GRANTOR S - " ^yi7
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Seller I-Na as appears on conveyance document Seller 2-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowled an bi f tjI rect
and�complete as required by law,and is,prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure .
/ . ./7�Ai iY)(/L-Q� AUG 1 0 7017
S nature of ,lfr Signature of Seller
Naf1w M l)11Sf7711(`J �l l7 n __—Printed Nam of Seller Sign Date(NM/DO/MT) Printed Name of Seller Y1ihw, ,FnhtF e(MM/DD/YYYY)
P=BUYER'S ',GRARTEE S _AP_PLICATION FOR'PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEQR T i ' ' a.' V. - "-an-34-`� .
I Mail 72nslec] ara "Mosley
'. Buyer I-Name as appears on convey nce document Buyer 2-Name as appears on nveyancedocument
r JO9 E Monroe, 61 . 200 6 MYlonioe /J f .
Address(Number and Street) Address(Number and Street)
JD ri n[a'-fmi, IN 474 70 '--Ri ll c-e fun, iN 4-7(e 7
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY'.o
YES NO CONDITION Y NO CONDITION C/A_ O�
is(❑ 1.Will this property be the buyer's primary ❑ 3.Homestead OL (/I
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A.:. :
residence? Provide complete address of primary ❑ 4.Solar Energy Heati ;,,stem
residence,including county: ��--,,�f /y 4;
)09 E IYlonmt f- ❑ u 5.Wind power Device qG0
,S. s. (Number and Street) I ❑ 6.Hydroelectric Power Device /t
'" h RCP-�'ZIN, f� 47�170 C�"1' ll50)1/4_ ❑ IC 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ $ Is this gerty a residential rental property?
vacated for this residence? If yes,provide ❑ r 9.W i ul u like to receive tax statements for this
complete address of residence being vacated, s 4 se'ty is e-mail?(Provide contact information
including county: C , I Below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
City,State ZIP Code County 2 4 -/ -G 7 A/0 3 0000 5LOa8
Primary property owner contact name E-mail