HomeMy WebLinkAboutHomestead_Fox (6) i
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
I _p:P:RE$ARER c x_ - — -.,,.,—
�LJ Li cr tIn s !
Saephat-
Preparer of the Sales Disclosure Form Title
1—a- E r3ru ry pfd —
Address(Number and Street) Com an y RIr. ncenn Itj -1-Maio RI a
n -7-4 R IS -6vS;)
Ick
City,State,and ZIP Code Tele phone Number E-mail
E:;SEL'LER(S (GRANTOR(S)r .. r, 1,7 77 . . c.r" , i
- ■ 1 c.l.l 1 t VILA",
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
-i1- E ''rw-rt field kvc-
rress(Number and Street) Address(Number and Street)
rtacekor, 1u `Cic,j-o
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
anti o' plete as r• . •Fred by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
ti nature OS- Cr Signature of Seller
% pHan'IQ "31.A.11; 121- OkA II"tn
Printed Name olSeller Sian Date(MM/DD/YYYY) Printed Name o Seller
I Sign Date(AI N/DD/YYY1}
&F(,BU\'ER(S)%GRANTEE(S ARRHIGATT9NzF,ORIPROPERTY'TAN])ENUCTIONS-DIDENTIFYWALL;ITiEMS'THAT,`APQP,CYi, . " 1,`::771
ya.rre\o P6X Y
Buyer l-Name a ears on conveyance document Buyer Name asa
on y appears on conveyance document
LS Ike— (nDLI S. -Pf i rice
ess(Number and i treet) Address((lumber and Street)
I it eto
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERT SEM1TIFYAL THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
X ❑ 1.Will this property be the buyer's primary Jam` ❑ 3. Homestead
residence? Provide complete address of primary 4. Solar Energy Heating/Cooling System
residence,including county: ❑ $ 5.Wind Power Device
Address(Number and Street) ❑ , 6.Hydroelectric Power Device
❑ --g) 7.Geothermal Energy Heating/Cooling Device
City,State PCode County
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property?
vacated for this residence? If . q. e ❑ 9.Would you like to receive tax statements for this
complete addre r I ace n.ir:ted, property via e-mail?(Provide contact information
including county 1 1, J below.Please see instructions for more information.
Not available in all counties.)
Address(Numberand Street) AMC t 6 2Ul1
City,State ZIP Code tf lU County � ����-� � - � �0��