Homestead_Ziliak INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Miriam R. Price - Attorney
Preparer of the Sales Disclosure Form Title
43 N. Krinole Place, P.O.Box 100 Price&Associates, LLC
Address(Number and Street)
E-mail
E.SEL ER(S)/GRANTOR(S)
Adam Frantz
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Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
`d�':' � /1 k. 1-1-Au c n Or`.
Address(Number and Street) Address(Number and Street)
Elberfeld.IN 47647
City,State,and ZIP Code City,State,and ZIP Code
E-mail Telephone Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
_
A-e.^- e(Signature ofSeller / / Signature of Seller
Adam Frantz 0�/a2 I/.20,2-0
Printed Name of Seller Sign date(MMM/DD/YYYY) Printed Name of Seller Siyn Date(MM/DDLYYYY)
F.BUYER(S)/GRAIVTEE(S).--APPLICATION FOR-,PROPERTY;.TAX DEDUCTIONS—IDENTIFY,"ALL'ITE S PP I,
' D '''
Wanda Sue Ziliak , ..
pears on conveyance document Buyer 2-Name as appears on conveyance document
8265 S.850 E. MAR 5 2020
Address(Number and Street) Address(Number and Street)
Buckskin, IN 47647
City,State,and ZIP Code City,State,and ZIP Code
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDII
0 ❑ 1.Will this property be the buyer's primary CT ❑ 3.Homestead
residence? Provide complete address of primary -❑ 4.Solar Energy Heating/Cooling System
residence,including county:
8265 S.850 E. ❑ 05.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Buckskin, IN 47647 Gibson 0 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 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 0 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)
At,-oJ _ d .? -/ao - oov •pC 3 -oo/
City,State ZIP Code County
Primary property owner contact name E-mail
Number License/1D/Other Number