Homestead_Thoman INDIANA SALES DISCLOSURE FORM SDF ID:
,.D�PREBARER a-_, Page
Robert Meeks
Preparer of the Sales Disclosure Form Tide
1022 E Broadway St
Address(Number and Street) Company
Princeton IN 47670
City;State,and ZIP Code Telephone Number
E-mail
?E.AITER S GRANTORS 7 ; a t - s 97.V - 7 sq l t r Lic .r {� t alt say act,.- _
( )/ ( )lam-1.�:.Sr �� __l ��-_ - l) a-'.1_�.....s�?.__� 3�nrE3�)�._L�_)Yfl wi.�i�10 LC L:- ti3�6'ML
• Wiper Corporation
! Seller I-Name as appears on conveyance document
17962 Foxborough Lane Seller 2-Nome as appears on conveyance document
I
Address(Number and Street) Address(Number and Street)
i Boca Raton FL 33496
City,State,and ZIP Code City,State,and ZIPCode
Telephone Number 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".
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Signature of Seller L I IfF'lL Co h1' Signature of Seller
CMfTjrfsrji,D____C__g Ffl 1WPp1ei
•dName of Seller Sign Date(MM/DD/YYFY) Printed Name of Seller Sign Date(MM/DD/YITF)
.BUUYER(S))/GRANTEE(S)'IAPPLI TIONFORpROPERTY TAX<DEDUCTIONS=IDENTIFY-AL•L ITEMS THAT APPLY.. _ - _ _,
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' Buyer I-Name as a ears on conve ment Buyer 2-Name as appears on conveyance document
lvlcjctmt j l
/ f A'"-ess(Number and Street) Address(Number and Street)
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USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPS IDENTt THOSE THAT APPLY.
YES CONDITIONNO YES NO CONDITION IL'11 ,`"'t' j
Tr.. Li Homestead INtlt_'t a , ,.Will this property be the buyer's primary ,
residence? Provide complete address of prima n Ifs4 lar Ener ting/Cooling System
residence,including county: ❑ ka 5.Wind Power Device APR 2 3 2019
Address(Number and Street) ❑ II- 6.Hydroelectric Power Device
❑ RI 7.Geothermal Energy H tin vice
City,State ZIP Code County
❑ 1I 2.Does the buyer have a homestead in Indiana to be ❑ B.Is this proper f r � tgrl7ty?
vacated for this residence? If yes,provide ❑ Kt 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.
e m a coon
Address(Number and Street)
- 1°I -ag 315- Dzg
City,State ZIP Code County
name E'-
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my know e)ge an le ,Is true,correct
Number License/ID/Other Number