Homestead_Christie INblANA SALES DISCLOSURE FORM SDF ID: Page 2
D.XREPJARE Ms 3F�`yYa' `'� t•. eSk.F.W e z" s'�"- Iii esFNite..:..“>�Q.r
c /OF
'Preparer /the Sales Disclosure Form Title '
3111 6 r141 C- 8-C (Bess- A/4
• ` d ress(Numbs and Street) Company
• 7 TN 476 feO 6a - 6q-5--70 aelIoChLt
' City State,and ZIP Code Telephone Number •
v uncl- v
9 S LLER s ',GRAN1 R Si frff:.•. c1 rs c-e �
e,la- C.hnSlie-
Sellerl Name asp pears oq conveance document Sell N me as appears on conveyance document
Td -�hrisf(� 5j.l(/I�m I CA-CST6 tdecf
Adplress(Marvber and Street) d ress(Number and Street)
3l1/ /l o h Cfz gcestril� '. 7ko
C',State,andZlP Code !
Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance sv -IC 6-1.1-S.S,"Real P :Sales Disclosure Act".
"gnature•0-Her Sitgpature of Seger
t
J o . liars+, ' - /2-&t—!S' ep- %Uivi I-c /a-3/- /b'
. Print aukof Seller - Sian Date(MM/DD/YYYY) Printed hAime of Seller - . Sian Date(MM/DD/YYYYI
YES NO CONDITION
Ltd ❑ I.Will this property be the buyer's primary [ ❑ 3.Homeste r
residence? Provide complete address of primary Dar nergy Heating,FociIir g- yste
residence,including county: ❑ S.Wind Power Device
(ool.j. 61-A, 1 �1 QQ
Address(Namberand Street) ❑ N.' 6. Hydroelectric PowerQ-ecie I 2018
P At;CEr9J .ct) 117L 7D 6tAIin/ ❑ ['' 7.Geothermal Energy Hating/Cooli Device
City,State ZIP Code County � �
❑ ( 2. Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a restyyepp�lAen .,property?
vacated for[his residence? If yes,provide
❑ a9.Would you likel(i>' cerve 8" statemeKYs°11'this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: v.Please sees ions for more information.
C
vailable in all counties.)
Address(Number and Street)City,State ZIPCode Countytact name E-mail
Number License/ID/Other Number