Loading...
HomeMy WebLinkAboutHomestead_Dersch (2) T i . Ij DIANA GALES DISCLOSURE FORM SDF ID: Page 2 ip5,`PRE-PARErtr : - 'Tire.=cs,C.IpMETI i I.-:z' :L:1 -`; PAi Mt -` itici t JOna.n. na L T>&r-5CIn Preparer of the Sales Disclosure Form Title 330 C S S kIake, eC)QC1 S 3 Address(Number and street) E-mail • EE SELLER(S1aANTOR(S) -`L``rrail `>r:.:3' ^ rl .� ��: g - 4YII 3 P J: . II* -0 Seller 1-Name as appears oh-conveyance document - Seller 2-Name as appears on conveyance document s;yn 5. / init o eJ S/'a Lrr Address(Number and Street) ' Address(Number and Street) Clry,State,and j( pget ^VD Gh-i i ' „ "/h City,State,and ZIP Code Telephone Number�(y/� _le ,n-/�j //E-mail Telephone Number E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and compl a as require law, rregared in accordance with IC 6.1.1-5.5,"Real Property Sales Disclosure Act". QD S/-5:I77 Signature ler / yy� Signature of Seller 1 // ' _ rI' / d' � -- / � �� Printed I- , of let Sian Date(MM/DIMITY) yrtnted Name of Seller - Sian Date(.eM/DD/YYYY) s rYEliS)/.GPANTEE(S) APP LIEATI• T10R,,ROP•ERTtYa-TAX•1" II UCTIONS:IDENTfe Ai ITEMS(TP+ATAP,P,LY ¢;' ` ., 0 A • • ► - . c-h it den E. . der:-ch ) Buy- - I." .n "anted•• lot 3, ©c1 Mat. 12ood S I- oq • 5 t*t P,on-cl S -4 Address(Number and Street) Address(Number and Street) OGNICi EAnJI et in--I , zU I-A14:bo • OatcloorvA Ci+ , IN 4- toeo THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION ❑ 1.Will this property be the buyer's primary ® ❑ 3.Homestead residence? Provide complete address of primary ❑ O. 4.Solar Energy Heating/Cooling System residence,including cou ❑ 3 J°c) 3 C�ke ?7 d J S.Wind Power Device Address(Number and Sleet) ❑ 1l 6.Hydroelectric Power Device DAC-I CV\d City ZKI u-1 4-16(OTI ❑ ® 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code I 1 County ❑ ® 2.Does the buyer have a homestead in Indiana to be ❑ $ Is this property a residential rental property? vacated for this residence? If yes,provide ❑ p 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. 6 Not available in all counties.) �� Q 0 Address(Number and Street) 1 l22t 0-0 -0 b �Jr . -13-2G -400-00O. 0O ,� City,State ZIP Code County r maryr -°^'^ ^ mil