Homestead_Damon i
1 INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
1DPREPARER t -. .:• - w7•
I Sarah M_Oan,On buyer
Preparer of the Sales Disclosure Form Tide
530 NI. MSLlison Snit nor.
Address(Number and Street) Company
D0.k14ea Ciky , Ild gl61-e0 E12-44S-1142195 cot al,,ty 1 lrnort C r� Snlq I Rpm
City,State,and ZIP Code Telephone Number E-mail
EtSEhtER(S)JGRANTOR(S) J
R&-CR LEE J'/7 o55
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2-12— S. C'ounk-y (Zowc1 150E •
Address(Number and Street) Address(Number and Street)
Dur11 or , IN 4'514R
City,State,io PCode City,Sta re,and ZIP Code
112 -19%-1433 RIC-
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.S,"Real Property Sales Disclosure Act".
• � � ` ss g OMONTRACT
Signature eller Sl naW
ROGER LEE /r)o55 6613o/201'i
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name ofSeller Sian Date(MM/DDmTY)
iF.;BUYEl3(Sj'/ rf1P LICATIONFOR'PROPERTYTAXDEDUCTIONS-IDENTIFYALLITEMSTHATAPPLY ,..- "''.- ^S't
SARRAff I'FM at/ V;air(%0. M kh• Burardt
Buyek ame as appears on conveyance do .ent Buyer 2-Name as appears on conveyance document
59►-3, • •i5on r,t 53b IS .Madt5bn 511-pi*
Address(Number and Street) Address(Number and Street)
DaklanA CI1-) .115 . f-I11Fle0 Daktan\ C;Ftk IN LI1iI00
C:y,Stat4 and ZIP Code City,State and ZIP Code T
Bn ya9 1 rlh n
10105 sg .�4{ OlQlC;\.eM q hon y49 b51Dq v.� b •• eaDi ll
TelephoneNumber E-mailJo Telephone Number
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE PL
YES NO CONDITION NO CONDITION
Er ❑ 1.Will this property be the buyer's primary g ❑ 3.Homestead a)
MAY 31 2019
residence? Provide complete address of prima ❑ ® 4.Solar Energy�lEating/Cooling System
residence,including county:
53 0 /✓ /wrai5o,✓ SST 5.Wind Power Device rI,
Address(Number and and Street) ❑ Q 6.Hydroelectric Power��INcc 'k'(
OtKr�fNA ATy , 1/ LI766,0 G1f3.So/4/ ❑ ❑ 7.Geothermal Device
City,State ZIP Code County
❑ 0 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 ❑ Q 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.P nca cop inctrurtions for more information.
otavailable in all counties.)
Address(Number and Street)
tk—Vig -vo4- coo :2_to-oo .
City,State ZIP Code County
Prima owner contact name 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 Amite:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being ed.)
ac� t 1)1 a ON-
- ��
Signature of Buyerl Signature ofBuyer2/Spouse
A S co-ah M.Dsmon v 05 )30I201S ‘cktr'ta M• gurkh 4rat 05I3OI2011
Printed Legal Name of Buyer I Sign Date(MM/DainT) Printed Legal Name of Buyer2/Spouse Sign Date(MM/DD/YYYY)
02510 1N to2S03 151.S,1 H4 Z5' 4
Last 5 digits of Buyer I Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security
License/ID/Other Number Number License/ID/Other Number