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Homestead_Cullivan 1 I INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D PREPaARERS = Y C�CL Q i k c van . _.. Preparer of the Sales Disclosure Form Title ! `;C7� r Q SA- \\\5'- Address(Number and Street) Company Pi--o v-,4 -T J L1'I�u E-mail E SELLERS GRANT01t S t - > r V.0 Seller 1-Nate as appears on conveyance document Seller 2-Name as appears on conveyance document l5LfS S . uVph.l A,,e_, At-dress(Nummber and Street) Address(Number and Street) V( vtc-Q-Nil,e-c7(-Pa, / S W City, E-mail Telephone Number E-mail I Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". t?�� ' - tare of Seller Signature of Seller Gl f Iu6l c (IV 4-e—v\ Printed Name of Seller. Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YVVY) F BUYER(S)/GRANTE_E(S): 014:14CATION FOR PROPERTY TAX;D:OI TIONS IDENTIFY ALL ITEMS THAT APPLY,_ A-::7,-,::_ =21 Buyer 1-Name as appears on conveyance document y Buyer 2-Name as appears on conveyance document 3 0l n .! i F eks'4- f'11',\\ SA- Address 1!,a Address(Number and Street) Address(Number and Street) 'LED . .,.,—, City,State,and ZIP Code City,State,and ZIP Code (h)� �. A t3 ���Q Lo DEC 3 2020 Telephone Number 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 j;LY.•�_I. ill i YES NO CONDITION YES NO CONDITION 'COUNTY 1.Will this property be the buyer's primaryI�� GIDCON'COUNTY At MITOR ❑ p p ty y ❑ 3.Homestead residence? Provide complete address of primary ❑ S., 4.Solar Energy Heating/Cooling System residence,including county: El 5.Wind Power Device 30( et)c S's-i- n� ,1 \ �� I�� Address(Number ands •` ❑ Jr, 6.Hydroelectric Power Device ‘c6 2.42t --\-d•) ❑ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ /- 2.Does the buyer have a homestead in Indiana to be b 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 contact information including county: below.Please see instructions for more information. Not available in all counties.) 0� Address(Number and Street) \ s .._,L.kg_DLL.,__‘:2..‘,-04-2.14- 3D'-'0 0 0, 01‘.I... .iice, .. City,State ZIP Code County Primary property owner contact name E-mail h Number License/ID/Other Number