Homestead_Shamsaie •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
:EDWEPAR d- , '-ir `: .a -, Y- 'acere ; '
Robert E.Zoss,Sr. Attorney
Preporer of the Sales Disclosure Form Title
2405 N.Green River Road Bob Zoss Law Office,LLC
Address(Number and Street) Company
Evansville, Indiana 47715 812-471-8502 ar(azosslaw.com
City,Swte and ZIP Code • ' Telephone Number E-mail
s" LLER RANt IOR AC Wis _esxr ..rr:17,4-;s 2--■ . . ..- .. ..`r/'T� `J�.,.s ".
Shayegan Shamsaie -•
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
25 `1( w. TcfLIC Dr.
Address(Number and Street) Address(Number and Street)
Pr ;n ce LyOn r IN Lf7 g79
Under penalties of perjury,-,Lherebytertif}'that this Sales Disclosure,to thebest of my knowledge and belief,is true,correct
and complete as requir d by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
v A /c--4 3- 12- /8
Signatu eof tiler - Signature of Seller
Shayegan Shamsaie
Printed Name ofShcer - • Sian Date(HM/DD/YYn) Printed Name of Seller Sian Dote(Mn/DO/n»l
nUY,ERMY:GRANTEE(SWAP,P,LleiVIAQNWCWIROPERTY�TrXilEpUGT;IONS-IDENTTF,Yq•I.L'ITEici AH like _axacf,-
_ Shelly L.Shamsaie
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
2541 s( umb Julie r and �A
Address(A'umberand StreeQ Address(Number and StreeQ .dVJ
THE SALES DISCLOSURE FORM MAY DE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAI "-
YES NO CONDITION - - YES NO CONDITION CO�1/�yt;/.
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead q
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling Sys emmTOR
residence,including county:
❑ rA 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
eery,State ZIP Code County
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ n - 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 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)
• Gry,Smte ZlPlode County 2 &,-// -/,5_/O / co ?, /(7 03, 7
Primary property owner contact name E-mail