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Homestead_Caalim
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ,D;PREPARER: ` ,_ Lynette Murray Processor Preparer of the Sales Disclosure Form Title 2301 N Burkhardt Rd First Advantage Title Address(Number and Street) E SELIIERCS)/GRANT,OR(S)_ •. _.. - -% .. _. . ..- - _. . ._ _ _ '. ._. Keith J Bastian Shannon R Bastian f9I 1-Name as ap ears on conveyance document Seller 2-Name as appears on conveyance document Address Number and Stre t) Address(Number and Street) R/ float. 7 " vWZ5- certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and comp,4 c ired by law,and is prepared in accordance with 6-1.1-5.5,"Re as Disclosure Act". Signat •.,Selle ignature of Seller Keith , Ba ian 1a'11-�.OL. Shannon R Bastian I? I1"/11il Printed Name o Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) :F UYER`(SVORANrTEE(S)`, I PPI ICA 11:6W'OR:PRQPERW TAX-'DEAUCTFIONS.IEDENTIFY AL`LJTEMS,TkIAT APPLY Z,- -: ! Maria Sally L Caalim Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 321 DSO S Address(Number and Street) Address(Number and Street) of \ �n ck IN � 69 - i, City,State,and ZIP Code City,State,and ZIP Code CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE T T APPLY. u.<20r9 YES NO CONDITION YES NO CONDITIONG,eS !7 ❑ 1.Will this property be the buyer's primary X. ❑ 3.Homestead��Co(i - residence? Provide complete address of primary ❑ © 4.Solar Energy Heating7OSystem esiiidencecncluding county: ?,_,,TC 321 E -Ko ❑ 05.Wind Power Device R Address(Number and Street) ❑ 1 6.Hydroelectric Power Device FD f + Sf gt.f1 Cli f I �' 41(>�1$ (S 1M ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ Xr 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ [0 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,State ZIP Code County Of /9 / 9-do 4e°617. 0742-oa& License/ID/Other Number