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Homestead_Helmling I INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D+RREPARERi ^ � sz �79/ch�zC/._., yc /ih/, )S Preparer of the Sala Disclosure Form Tide -73i F' Totc Address(Number and 4Sweep) f ` CB II 7 �` 1 Companygia b g 6City,State,and ZIP Code Telephone Number E-mail (Efts/ELLER(S)%OR )`:ANTOR(S . . ' SellerI Name s appears on conveyance ocvmenc Seller 2-Name as appears on conveyance document 60# 0YS /c-/ SO/v A ress(Numberand Street) Address(Number and Street) V4b/7S ,J,/L� ry i/77 i9 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 an �plete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". iigna re of Sell 4— �� �� Signature of Seller lr-n� me l/� rf / it? Printed Name of Sell r Sian Date(MM/DD/rr1'Y) Printed Name of Seller Sion Date(MM/DD/YYYY) rE BUYER(S)%GRANTEE(S)=ARPLICATION.FOR`PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT-APPLY: 7 ill �a / /A / 1 r Buyer I-Name as ap rs on on conveyanced meat document -795 r - ram _ Buyer 2-Name as appears on conveyance FILED Address(Number and Street) Address(Number and Sweet) ✓9R //SO/ CI Ie7e Q171 / 2- FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APP • YES NO CONDITIONIYES NO CONDITIONGIBSON COUNTY AUDITOR ] ❑ 1.Will this property be the buyer's primary C`� ❑ 3.Homestead residence? Provide complete address of primary r sidence,'in/cludin�S county: l ❑ ❑ 4 Solar Energy Heating/Cooling System / g. 05 1 /.V• S TomeA j2C). ❑ ❑ 5.Wind Power Device Address(imb r4;;Street) // /// ❑ ❑ 6.Hydroelectric Power Device Q �j! Y 7(� 6 ❑ ❑ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ I] 2.Does the buyer have a homestead in Indiana to be ❑ ❑ 8.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) (�/��/ I 4�^{/ •/^/ City,State ZIP Code aG ^ 1 /- -.3p _ t©o- ?D •LS County 11/ner J Primary property owner contact name E-mail Number License/ID/Other Number