Homestead_Bradshaw INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Preparer of the Sales Disclosure Form _ Title
50 5 0 I(YIOW St ,
Address(N berand Street) �_
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Seller 1- ame as appears on convey ace document Seller eassk.p•,-..f,.n conveyance document
75 0) Th s�- _ __A
Addr(NumberpndStreet) , j�� ` Address(Nu-%er c7�Xt)
Co
City,
Telephone Number c 441. E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge'n.i(',Alref, " '"•._ correct
and co plete as requi d by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sale- I ,s:su jr Act".
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Si natu e of Seller Signature of Seller
Printed ame o r Sign Date(MM/DD/YYiTl Printed Name of Seller ,‘ `y Siqn Date(MM/DD/YYYY)
F;BUYE IVTEE(S)=APPLICATION.FO .P, PERTY TAX=pEDUGTIONS;'IDENTLFYrALL ITEMS sis :A,..: ; y Y_�, ` 7 -
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f//er1-N mea appears onconve ance document Bu er2-Nameasappearso n a d ent
1 Address(Number and Street) Address(Number and Street)
. 1 e , 0 % S�e �(0R
E-mail, Telephone Number (A\ �� E-mail
THE SALES DI LOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUC ONS FPR' IS PROPERTY. IDENTIFY ALL OF TH E�HQ(��PPLY.
YES NO CONDITION ` // ICES_ 0 CONDITION C3�\
�❑ 1.Will this property be the buyer's primary [V]t• ❑ 3.Homestead
residence? Provide complete address of mart' ❑ IKK 4.Solar Energy Heating/Cooling System
residence,includi county: /
30,E �S, v 1 ❑ �r[j,/' 5.Wind Power Deice
Address,( umberandStleet) ,/ ❑ Lr 6.Hy_droelectric Power Device
rr//���'a'1.',e jiiii `4 G 90 50il ❑ [" 7.Geothermal Energy Heating/Cooling Device
City,State ZlP ode County
❑ [I/ 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 ❑ LId 9.Would you like to receive tax statements for this
complete address of residence being vacated, operty via e-mail?(Provute-con-ta in ormation
including county: i structt s or more in or 'on.
Not available in all counties.
Address(Number and Street)
aU-oa— sCi,-°rl- nDO . l- 4 0ICI
City,State ZIP Code County
Pr property owner contact name email
License/ID/Other Number