HomeMy WebLinkAboutHomestead_Donnell (4) INDIANA SALES DISCLOSURE FORM SDF ID: _ Pa:e 2
D.PREPARER .
k ãd -a& L - t't{��2.auir Settlement Agent
Preparer of the Sales Disclosure Form \I Tide
662 Woodward Ave. Title Source, Inc.
Address(Number and Street) Company
Detroit, MI 48226 C C - 5<t-66 'S355—
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) . _
Patrick J. Donnell
Seller I .Name as appears on eonNsunce document Seller 2-Name as appears on conveyance document
1>0/ ,io Lec T
A dress(Number a d Street) Address(Number and Street)
i
Under penalties of perjury,I hereby certify that this Sales Disclosure, to the best of my knowledge and belief,is true,correct
ands. ete d b __-__ s prepared in accordance with IC 6- 1.1 -5.5,"Real Property Sales Disclosure Act".
' Si .attire of Se Signature of Seller
Patrick J. Donnell 61/31/2uf(t' i " i t i----:„.
1 Will this property be the buyer's primary ❑ 3.Homestead
residence?Provide complete address of
primary residence,' eluding county: ❑ 4.Solar Energy Heating/Cooling System
figO� le n4 Q„/,' ❑ 5.Wind Power Device
Address(Ny�p�•qnd Street) _-*�/'J - 16 ❑ 6.Hydroelectric Power Device
< r/ Ace-ken S./ `r 7(070 ❑ rr 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code I County
❑ RI 8. Is this property a rental property?
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ [ 9.Would you like to receive tax statements for this
vacated for this residence?If yes,provide I�
complete address of residence being vacated, property via a-mail. (Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
o•,/p _ / 1 - o8 - ?o3 - 003. /es.3 - 0Il• �
City.State ZIP Code County Primary property owner contact name E-mail