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INDIANA SALES DISCLOSURE FORM SDF ID: • Page 2
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Preparer of the Sales Disclosure Form I Title
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Address(Number and Sake) Company
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City,State.and ZIP Cade Telephone Number E-mail
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Seller 1-Name as appears on conveyance document Seller 2-Name as appears on cenveyance 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 knowledge and belief,is true,correct
and coin lete as equired by,law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller Signature of*ler
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Printed Name of Seller . Sign Date(HMO WYYYY) Printed Namb of Seller Sign Date(MM/DO/YYYY)
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B ''r 1-Name as appears on conveyance•ocument Buyer 2-Nome as appears on conveyance document
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Address(Number and Street) . Address(Number and Street)
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES No NO CONDITION I YESflION
El 0 1.Will this property be the buyer's primary (I 0 3.Homestea* GIBSON COUNTY AUDITO
residence? Provide complete address of primary Li zi 4.Solar Energy Heating/Cooling System
residence,including county:
n [ ] 5.Wind Power Device
0? RI a i d Rife-
Address(Number and Street) - 0 a 6.Hydroelectric Power Device
nr.k/a Add C i ry,-rd. Lfrpo id) re',bso,0 n N 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 N 8.Is this property a residential rental property?
n 0 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide El 0 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) 4 --/3 ../J . zio,2 -Oa/.?.3 " -0° 7
LLi i i .,4*{, ,5-No hi tK ), €151@ Aloe),
City,State ZIP Code County Lthn
Primary properly owner conlact name E-mail