Homestead_Georges (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Elysea M Ledman Settlement 8 Quality Assurance
Preparer of the Sales Disclosure Form Title
3930 Mezzanine Drive. Suite C Columbia Title, Inc.
Address(Number and Street) Company
Lafayette. IN 47905
T i''rt 777 T •7r_ y-t'-;_ s.. i "a. T'_•1 w1.-� ri_ i.� '-s
,E.'SE E�S�/GRA\TO'R($Ji_ '--- —" - ;---'5 _ .a ,q i J +. * ?. `a.r
Aenan Manion
„TIT:ppelSo con'e}n le document Seller 2-Name as appears on conveyance document
Ad e •(N't eraa S:rep \ i?AS/ Address(Number and Street)
rel ill 1 I'tv1 l� `/
E-mail Telephone Number Email
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
andd�complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
•
Signature of Seller �12 Signature of Seller
I Aenan Manion — �D- \C\
Printed Name r Sian Date(MAt/OD/IYYY) Printed Name of Seller Sian Date(.MM/nD/1YYY)
F' _ -Sjf,6i2>•k1,'iEE(S)• _APPLIGATIO :F,OR^PROPERTY711.4XD,ED-UETIONS=/IDENTIF2tAI:L ITEMS_THATAP:FkY,___ _ - - _
Thekla Georaes Alex Manion
B rI-Nam s appears on con- a edocu t er2 liam pasappears onm ryynce docy=enl
+'s (4. I° 41( . J rrs Nuua erUrest /U —7 I c'
❑ 1.will this property be the buyer's primary I 14 ❑ 3.Homestead 1`'
residence? Provide complete address of primary ti / i4CSAystem
r I enc incLld' g co ty: ❑
liij I 3 ( In C. )� 5.Wind Power D 'ic ,lO\g
Addregs.(,vtr'nbera dmreet,j ) Lo�'s �- ❑ 6.Hydroelectric Power Da�jcrl
Iu ` .tr —{c h v stain ❑ 7.Geothermal Energy Heating/Co [Ina evice
City,State ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a resid ial' �� �F
vacated for this residence? If yes,provide Ill , 9.Would you like to recei > ements for this
complete address of residence being vacated, property via e-m.' 1.1 40i a contact information
including county: below.Plea --• instructions o c • 'n ormation.
Not available in all counne .
Address(Number and Street) t����) .
City State ZIP Code Count_ a(0'ac --- -BOO- — " I RC), ,o
Primary property Owner contact name