Homestead_Sollman (16) INDIANA SALES DISCLOSURE FORM SDF ID: Page
D.PREPARER
Rexanne McCauley Title& Escrow Processing
Preparer of the Sales Disclosure Form Title
3930 Mezzanine Drive, Suite C Columbia Title.Inc.
Address(Number and Street) Company
Lafayette, IN 47905
E.SELLER(S)/GRANTORS)
-. ..i- A - ne Jones Melissa Dawn Jones
Se m. -Name as appears on conveyance document Seller 2-Name as appears on conveyance document ^ ,
uk 5 -TV rck A-csQ
Address(Number and t 1t`.A-ddd`ress(Numberu on Street)
City,State,and ZIP Code
E-mail
Under penalties of perjury,I hereby cert 'that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prep. ed in accordance with
/IIC6-11..1-55..f5�,"Real%Property Sales Disclosure Act".
1aep—
Signature ofSeller Signature of SellerU
Christopher Wayne Jones Melissa Dawn Jones 0/2019
Printed Name of Seller Sion Date(MM r'/DD/YY) Printed Name of Seller I I Sipn � rya/VYnt
)`�GR F.BUYBR(SANTEE(�-APPLICATION FOR.PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITE ;. H;.T PE1 f ;i'
Corbin SollmaD? Shelbi C.Ziliak
• "Ituyer Are as appears on conveyance document Buyer 2-Name as appears on conveyance documhdlG 8 — 2019
11380 South 150 East 11380 South 150 East FFi1 UU
Address(Number and Street) Address(Number and Street)
Haubstadt. IN 47639 Haubstadt. IN 47639
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I 1•ES .A,.ss,T N
0 ❑ 1.Will this property be the buyer's primary I �❑ 3. Homestead
residence? Provide complete address of primary 7:1-17 4.Solar Energy Heating/Cooling System
residence,includin
11380 South 150 East g coun tY ❑ ❑✓ S.Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt. IN 47639 Gibson ❑ o 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Cade County
❑ IX 2. Does the buyer have a homestead in Indiana to be ❑ El 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ IZ 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.
Not available in all counties.)
Address(Number and Street)
aG A 3 . o9- lot -ow. Leo -d d'/
Cry,State ZIPCade County
Primary property owner contact name E-mail