HomeMy WebLinkAboutHomestead_Kays (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Preparer of the Saks Disclosure Form Title
l4' g 2 CON SFRJ>91tor- p2
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Address(Number and Street) Company
Parreccm-7 Tr LIerrX) fiia- ci44- (623
City,State,and ZIP Code Telephone Number E-mail
(E SEilER(V/,GRANTQR(S)T-r--T. _ ,_.. _-'4; '. [1:-.",,.» � _7__. ._ __ I
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Seller I-Name as appears on conveyance 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_c�omm 1pllete as required
by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(
Signature of Selle Signature of Seller
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Printed Name of Seller Sign Date(M.M/D /YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
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k] ❑ 3.Homestead
residence? Provide complete address of primary ❑ ® 4.Solar Energy Heating/Cooling System
residence,including county: ❑
0 5.Wind Power Device
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Address(Number and Street) ❑ 14 6. Hydroelectric Power Device
City,State ZIP Code County ❑ �A 7.Geothermal Energy Heating/Cooling Device
❑ [1 ' 2.Does the buyer have a homestead in Indiana to be ❑
vacated for this residence? If yes,provide ❑ ata1 IA��,1l 8.Is this property a residential rental property?
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)
a(o -la-0S- 400- 00- qss DaA
City,State ZIP Code County
Primary property owner contact name Email