Homestead_Brown INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D-PREPARER`
r
Dana Belcher Processor
Preparer of the Sales Disclosure Form Title
2301 N. Burkhardt Road First Advantage Title
Address(Number and Street)
E-mail
E SEVCR(S TA-Wit OR S - . .! a
Robert J Vermilion III Mallory L Vermillion f/k/a Malle L Deffendall
Sel'er.1-Name as appeal- conveyance document Seller 2- e as appears on conveyanc document
I 1-1 ) '' , rY _Lt---r 0 4)-r- avt).(__ _
dress(Number and Street) ' Address umber rua Street)
Lly,Stat, ZIP
E-mail
I
Un en ti s of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and a require law,and is prepared in accordance with IC 1.1-5.5,"R al roperty Sales Disclosure Act".
XSigns ure ler C�/ _X
llf ,�'gn•tur:ofSel2*r
Robert J.Vermillion III I 1�I Mallory L. Vermillion �� b�
Printed Name of Seller Sign Dbte MM!D( / /YYYS') Printed Name o/'Seller iq at M/DD/YYYY)
F B_ U 14-8)f GRA nt(S).-;APPLICATION,FORPROle-t Y TAX DEDUCTLON8 IDE.NTiPY A'LL;1•TEMS,THAT APPLY- ,94� 44 r ' _.:
Matthew G. Brown Breianna M. Brown ./ I jo i
B yer 1-Name as appears o c veyanc dQ, Buyer 2-Na a
ears on conveyance •cument /01
ess(Number and et) Address(Number and Street) /es e is
(,mil ( \-c_l.CC\ vU,‘ 0 i, oN .
City,
OF THOSE THAT APPLY. 0/?
YES NO CONDITION YES NO CONDITION
1 ❑ 1.Will this property be the buyer's primary ] ❑ 3.Homestead
residence? Provide complete address of primary j 4.Solar Energy Heating/Cooling System
resid incldcty
❑ ❑✓ 5.Wind Power Device
ddre ( nnberg cre�c �� 1�� L,( 1 2 6.Hydroelectric Power Device
lC 1C\C19C-4 (`,161H 1Z 7.Geothermal Energy Heating/Cooling Device
ity,State ZIP Code I County
❑ El 2.Does the buyer have a homestead in Indiana to be ill ❑✓ 8•is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 2 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)
City,StoteZlPCode County d�_/ / a9- goo- cod.A --
Primary