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Homestead_Brummett I INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 LANA C. HARPER CLOSER Preparer of the Sales Disclosure Form Title 5231 Oak Grove Rd.. Ste.A TOTAL TITLE SERVICES, LLC Addres(Number and Street) Company EVAN7CVILLE. IN 47715 Email ESELLER(S)/GRANTWk(S) _ -- ' . Sue Fll°n Bpleat Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 9o7 61/L<50AJ A%)f/ Addres1(Number and Street) Adelress(Number and Street) icZ.in)Ce--o PJ ) I y7lo70 City,.Stale,and 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 complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". aeo/Lt ELn 1,0 6lio CAL SUp3uture of Seller .L� 2 Signature of Seller Sup Filen Reloat / J /9 Printed Name of Seller Sian Date Les:/UD/fn) Printed Name of Seller Sian Date DDt/aa/iTYI) 'F BUYI R(S)%GRANTEE(S)'-_''APPLICATION;F,ORiPROPERTaYTAX'DEDUCTIONS_IDENTII Ya1T I'ITEMS,THAT-AppLl ,, L ' -°' aura - Brummett \ ��p� ��� ED^ OK1" � ^n �J,'nveynnredrcwnent Qvyer2"A'omeasaplxarsanronveyan�u�•r� 0 .72r& /&w Aim,.a(Nu bar and Street) Address(Number and Street) I' �l N �{7(c�� APRs 7019 City, E-mail Telephone Number E-mail TIIE SALES DISCLOSUREFo RM MAY BE USED TO APPLY raft CERTAIN DEDUCTIONS FOR TIIIS PROPERTY. IDENTIFY ALL OF THO$E 1 'P�bUNTY AUDITOR YES , ,NO CONDITION I .5 NO CONDITION W bI ❑ I.Neill this property be the buyer's primary 12- ❑ 3. Homestead /_Q residence? Provide completeco address of primary u -+.Sum toriby eating/Cooling System 6 90 Ssic(eLCPt)a u1i t}gr"C1le:Ta L ❑ ❑✓ S.Wind Power Device py.Jress(timber/r,�ysvoet) Al ' r ❑ 17 6. Hydroelectric Power Device ' `�/� '✓r��C/� �' " 7��� " /`'�501 ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ ❑/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 ❑ 1Z 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 snore information. • al a le in all counties.) Address(Number and Street) (y� 1 /e� City State ZIP Code county C l0 - ` - aot� .0o0 . 55.0 - oar " p-T+•+•-^r.n.^-r ,er °mart name E-mail Number License/ID/Other Number