Homestead_Royalty i y
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
L'b:,PREliARER - r . ._ A_. ... i. ". . is ,. ;
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Preparer of the alesDisclos' Form Title
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I i4dress(Number and Street)
; E-mail
•E.`SELLER(S)/GRANTOR(Sj .. • ,
r or; IJrtt Ci1q -I
Seller 1-Name as appears o?conveyance document Seller 2-Name as appears on conveyance document
SNo w ` 00S 0 I
Street)Address and
(Number Address(Number and Street)I
City,State,and ZIP Code City,State,and ZIP Code
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Telephone Number E-mail Telephone Number _ - E-mail
E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to th r'"". .Ilk °cow edge and belief,is true,correct
and V�mpplete as requuid by law,and is prepared in accordance with IC 6-'41-5. , 1 Property Sales Disclosure Act".
Sig atureofSeller l//�•C Signature of Seller
—Wn
ted Name of Seller Sign Date(MM/DD/YYYY) Prin'tetl Name of Seller Sign Date(MM/DD/YYYY)
.BUY EAR(S)LGRAANTEE S)-APPLICATIN F OOR R� DEDUNS=CTIO 'IDENTIFY ALL'ITEMS T pLY
Buyer 1-Na as apf pCear n conveyalice document Buyer 2-N e as appears on conveyance document
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Address(Number and Street) Address(Nu ber and Street) FC11,
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Qe\nce' tr , TN `--1l(c•l0 e�
E-mail elephone Number �/ L E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUC"LWN3FOP.THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY:` ,q0
YES NO YES NO CONDITION 0/T
❑ 1.Will this property be the buyer's primary ' ❑ 3.Homestead :7,
RI/
residence? Provide complete address of primary ❑ [ ' 4.Solar Energy Heating/Cooling System
• residence,including county: 5.Wind Power Device
10 1 S. Ven t- �. Pc ,n(—-*—um I _Lt�1 ❑
Address(Number and Street) ❑ [Y 6.Hydroelectric Power Device
\\D'O:CI C l IA—ill-1 ❑ [ " 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
E y 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 ❑ [' 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail? Provide-c act information
including county: be se see instructions form . ormation.
Not available in all counties.)
Address(Number and Street)
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Number License/ID/Other Number