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. INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:PREPARER •' -':: i-:L.,ii.7. •-•. :.':.:::.';••••:4::t,'": '-',"::-'' .:,';'•••.•:-:. :: ::- : •:":' '' ;:.::':,.:'-'.;: :'.4'6.:i;:r.,'.,: ;'' :::;'''',.:•K..-•?'.::,:.'):''.:','.;•-•::-::$;:t.t..i.f-' 7.:.-- :.'', ..' . ;
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Preparer of the tales Disclosure Form Title
F629 /V 531 Ck) .
Addr s(Number aZreet)
E.SELLE1 (S)/GRANTOR(S)1::'1::: ':•.:::''','T..•;' ,.: , i '',:',f: :':.;.;,'' :-.:
5..(.0 744 17 a /e'r---5.i 1-7‘ et-3c
Seller I-Name as appears on conveyance document Seller 2-Na as appears on conveyance document
e0,9A/ 6-66(-) ro 9 9 iv 5-- 6,,_,
Address Number and Stregt) =Number and Street)
Altai 1-44 _TA/ VX V, 24,74,
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and mplete quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Re I Property Sales Disclosure Act".
1'
igna tore'[Seller Signiaztuzof Seller
''' , _._ •c.,7/_• P .za 7 71-er30/ av "1- r -1
Printed Name of Seller Sign Date(MMJ0D/YYYY) Printed Name or Seller Sign Date(MM/DD/YYYY)
F.BUYER(S)/GRANTEE(S) .APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY,
Z-i. r< /19G a reor.a r
Buyer I-Name kf appears on conveyanceWocument Buyer 2-Name as appears on conveyance document
5—C72 0 Al 6('is.1 57- F I ,. ED
Ad rest(Number and Street) Address(Number and Street) ,,,, ..r-./ve A ..r1V V
16 73
FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THA PPLY.
YES NO CONDITION YES NO CONDITION i
v 0 1.Will this property be the buyer's primary IET 0 3.HomesteatIDIBSON COU 1Y AUDITOR
residence? Provide complete address of primary 0 3"-- 4.Solar Energy Heating/Cooling System ' v
residence,including county:
S.Wind Power Device
Address(Number and Street) 0 1E1'..'- 6.Hydroelectric Power Device
7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El ig'. 8.Is this property a residential rental property?
0 Er 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 0 g--- 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)
a 6— Irt -07 ---bok -00 1.(k y -0t-r •
City,State ZIP Code County
Primary property owner contact name E-mail
Number License/ID/Other Number