Homestead_Bottom INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER ._ . - . - •
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Preparer of the Sales Disclosure Form Title
1D0O . au4-ilegiriefe st
Address(Number and Street) Company
FoleA- O n COO Zl_I q (0II 91 .51) � -27 4 S3a8 Cc
City,State,and ZIP Code Telephone Number
E-mail
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Seller 1-Name as appears on c veyance 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 knowledge and belief,is true,correct
and cam fete as required 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 Seller
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Printed Name of Seller Sign Dote(MM/DD/YYYY) Printed Name of Seller
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'F.BUYER(S)('GRANTEE(S)=AEPLICATION;FOR PROPERTY_TAX DEDUCTIONS`_IDENTIFY ALL IT S_FHB'7 APF`L`, 1 !--.7- .
%-r r R nf+fl--)(Cc.n Int,D
as a,..s.. . .,once document Buyer 2-Name as appears on conveyance d4 Ent C
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. (o{Q.sa(1-h 09,04ek 51.
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 LY.
YES NO CONDITION �
N —EONDITION_
(�❑ 1.Will this property be the buyer's primary ,ji ❑ 3.Homestead
residence? Provide complete address of primary /ff .4.SolirEnergy eating/Cooling System
residence,including county: ❑ 5._Wind Power Device
Address(Number and Street) .L ` -r,' ❑ zr 6.Hydroelectric Power Device
/r.()()5. /'en+8P S1, Fre I �reQnr till G,1-fin ❑ 7.Geothermal Energy Heating/Cooling Device
City State Zl/P Code 91lot-I County
_❑ /L 2.Does the buyer have a homestead in Indiana to be ❑ B.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.
Not available in all counties.)
Address(Number and Street)
;4 - /9 - 1 9 - f o 3 - aoo • t-f/1 -o z4
City,State ZIP Code County
Primary propertyowner contact name E-mail