Homestead_Wilson (17) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Preparer'of the Sales Disclosure For Title _
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Address(Number and Street) Company
City tote,and ZIP Code e—^ - Telephone
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Seller Name as appears on conveyance document legit,' '2 . am as appears on co veyance document
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Ad ess(Number aryl Street) / Ad ss(Number a Street) �—
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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 as required by 1 w,and is prepared in accordance w4tfSe
C 6-1.1-5.5, Real-Pro S les Disclosure Act".
,4-7/11 / -,----N__--------1
Sign feller ller I
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Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller ":-Sign Date(MM/DDjYYYY)
F BUYERS } GRANT_EE S. ;;APPLICATION ORfPROPSRTY TAX D UGTIONS 1413310 ALL?ITEMS` Ifil AP ',_ _; ,_,_;4.=
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Buyer -Name as appears on conveyance document Buyer 2-Na s appears on conveyance document
4,0 P G.J; 57,E--ram
/id dress(Number and Street).--, Address(Number and Street)
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 MIA"RAI'LY. 2020
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary ,� ❑ 3.Homestead .
residence? Provide complete address of primary ❑ a 4.Solar Eel SI�I TUR
in
residence,including county: N❑ lZ 5.Wind Power Device
Address(Number and Street) ❑ ," 6.Hydroelectric Power Device
❑ L/J 7.Geothermal Energy Heating/Cooling Device
City,State Z Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ Z 8.Is this property a residential rental property?
- vacated for this residence? If yes,provide ❑ gi 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)
.6--12-o1 -'o3 -or. 3 6 2r o2P
City,State ZIP Code County
Primary property owner contact name E-mail
Number License/ID/Other Number