Homestead_Mason INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
VPRREPPRERE- r-,,.`3..: .- - i�X0
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Preparer of the Sales Disdosure Form Tide
P.O. QLSI 9L
jaaress(Number and Street)
E-mail
[ErSEELERO'/GRANTOR(§) - " -
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
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Ad ess(Number and Street) Address(Number and Street)
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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 c� required by law,and is prepared in accordance with IC 6-1.1-5.S,"Real Property Sales Disclosure Act".
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S" reo Sell t� Signature of Seller
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Prin ame ofShcer Sian Date(st4/aDEM) Printed Name ofSeller Sian Date(MX/WYMI
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E.S ERISJ/GRANTEE Si'-APPLICATION FOR OPERTY TAX DEDUCTIONS-IDENTI L1 T MS T IA.Y �•.;T4 zg
Ltd-- ill wSan Bet 1-t me as appears on con ace document Buyer 2•Name as appears on conveyance document
APR 292019
Ad (Number and Address(Number and Street)
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city,
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR T OFERTY.IDEN I u THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ 121 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary
❑ - 4.Solar Energy Heating/Cool g System
residence, including county:
❑ E 5.Wind Power Device
Address(Number and Street) ❑ la— 6.Hydroelectric Power Device
0 0-7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
Er❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0—8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ [3-9•Would you like to receive tax statements for this
complete address of residence being vacated, contact information
including county: below.Please see instructions for information.
Not available in all counties.)
Address(Number and Street)
City,State ZIP Code Co ry qg-13 —03 - . yig_O
Primary property owner contact name E-mail
License/ID/Other Number