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INDIANA SALES DISCLOSURE FORM SDF ID:
D.PREPARER Pagel
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Preparer of the Sales Disclosure Form Title
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Address(Number and Street)
E.S_LLER[S)[GRANTOR(S)
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Seller 1-Name as appears on conveyance document Seller 2•Name as appears on conveyance document
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Address(Number and St eet) Address(Number and Srreet)
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Telephone Num 7..
E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
andplete as required by law,and is prepared in accordance with IC 6 1.1 5.5, "Real Property Sales Disclosure Act".
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tgnature o Seller Signature of Seller
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Printed Name o Seller Si.n Date MM DD YYYY) Printed Name o Seller 'Si.nDate MM/DD/YYYY)
I F. BUYER(S)JGRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
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Buyer 1-Name as appears on conveyance document Buyer 2-Nome as ears on c
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A ress(Number and Street) Address(Number and Street)
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YES NO CONDITION 1
X ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System i
residence,including county:
❑ ] 5.Wind Power Device
Address(Number and Street) ❑ R 6.Hydroelectric Power Device
❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code # County
ID 2.Does the buyer v3�' Rm :yin I udia to be ❑ 8.Is this property a residential rental property?
vacated for& sip ? ' rtr ide ❑ 9.Would you like to receive tax statements for this
•
co-nua,.e :dill es of C sidt e being vacated, property via e-mail?(Provide contact information
• (1 yt,�-, .V,it,ty: below. Please see instructions for more information.
3
Not available in all counties.)
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