HomeMy WebLinkAboutHomestead_Mansell INDIANA SALES DISCLOSURE FORM SDF ID:
D.PREPARER- , . y Page 2
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SI us le .a at Preparerofthe Soles Disclos u1.:•rm Ti e a(�
A es(Number and Street) `` `` '7 /' camyp/°�"DY1y� Q� 2 Lt
-c)St rte, . ZIP Code LI N3 ( 670 ` 1_2 �(J J0 Lt-c'
Telephone Number
E-mail
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E SELLERS)%GRANTDR(S)
S eer Name asappears on mrt(•eyance document Seller 2-Name asa ears on conveyance PP eyance document
box. 19 .5
Address(Number and Street) - Address(Number and Street)
and co r ete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
J. 4, cS. _
Sgna of Seller
11n{l Signature of Seller
A
14 • C.- ID
Printed Name of Seller •n Da e(MM/DD/YYn] Printed Name of Seller Sign Date(MM/DD/YYYY)
F.$UYER(Sy GRANTEE(S)=.`APPLICATION•FOR RROPERT,Y TAX DEDUCTIONS:?IDENTIFYALL ITEMS:THAT-APPLY- I
V e u 4 T VY1a.r-ls c U
Buyer I-Name as appears on conveyance document Buyer 2-Name as ./ .I
0. Sox ( / / appears on conveyance d urslen�
Address(Number and Sweet) bra^j
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YES NO CONDITION I YES NO CONDITION tin
® ❑ 1.Will this property be the buyer's primary 21. 0 3.Homestead 20,9
residence? Provide complete address of primary
residence,including county: ❑ N 4.Solar Energy Heating/Cooling System
❑ N S.Wind Power Device
Address(Number and Street) ❑ V. 6. Hydroelectric Power Device
City.State ZIP Code County ❑ V 7.Geothermal Energy Heating/Cooling Device
❑ It 2. Does the buyer have a homestead in Indiana to be ❑ ® 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ ® 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.
�r Not available in all counties.)
Address(Numbergnd,Street) 0;/�- /�- r J-/Do- ^^0. 07- 01 •
City,State ZIP C pI� County PtJ�rSt'!�J` [ti..0-!/ 10 Est/-r���
( Primary property owner contact name