Homestead_Riley (7) INDIANA SALES DISCLOSURE FORM SDF ID: . . Page 2
'D:PREPARER_ r 7.. -_;_ :- . -_ — ___I ,_ 7-- '-. T -7'�. J
11^-6.444, w Foss 2ecord.:en Sptc'.c-l',sir
Pre parerof the Sales Disclosure Form Tale
61) -So rdG S4r,cc4 Epail-1 A/C_fi'o.‘o-1 T7-fLc_
Address(Number and Street) Company
e -u— Pros :Ae-.ce , (tL o2-o1 11-4 81SS -434-5-VVO wi s1e C,eu--s .'to,A,b.-..l . Le...
City,State,and ZIP Code Telephone Number E-mail
`.E:SELLER(S)`/GRANTORfSj`,_li. -, -7.o -- - _„1-__ :-.7.:,_G._-'' .. __ -, ,I -, , - 1
2Nce,c_\- Loanr - 0kc-n-clp.r 1 tam 2r1 S c ,fbtz .e`t
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
335 Uine_ S\-- r2Th S C)i lYeei-
Address(Number and Street) Address(Number and Street)
@a.\(__.\0..
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as require t by I.w,and is .repared in accordance with IC 6-1.1.5.5,"Real Property Sales Disclosure Act".
fr
Signal.of Sel er 'tore of Seller
I! . ' _ - /• GA -" y \ Flfh(c., T S} rrccie ✓ -!S -1 7
Printed Name of Seller Signbute(MM/D) I Printed Name of Seller Sian Date(MM/DDpYYY1
cE.B/,UYERS {GRANTEES s7 -EORP.ROPERTYLTAX DEDUCTIONS=IDENTI @Y'ALI:ITEMS� T' (Y -` i j
Vl'. aP/ -7:0/ .
:wirer l-Name asap rs on convyance document Buyer 2-Name as appears on convey redo
Address Numbers Street Address(Number and Street) AUG 1 '7 261i
4/)%11J4 , 1/r/ y7a o.
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
❑ 1.Will this property be the buyer's primary a ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
Address(Number and Street) ❑ [ ' 6. Hydroelectric Power Device
❑ [X 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 2. Does the buyer have a homestead in Indiana to be Li $• Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 4 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: below. Please see instructions for more information.
Not available in all counties)
Address(Number and Street)
City,State ZIP Code a 6 - I hi— (g- I b Li—Oab. 919 -Oa-)
County
Primary property owner contact name E-ma