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Homestead_Cullivan 1
I INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D PREPaARERS =
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Preparer of the Sales Disclosure Form Title
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Address(Number and Street) Company
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E-mail
E SELLERS GRANT01t S t - > r
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Seller 1-Nate as appears on conveyance document Seller 2-Name as appears on conveyance document
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At-dress(Nummber and Street) Address(Number and Street)
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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".
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tare of Seller Signature of Seller
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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
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Address 1!,a
Address(Number and Street) Address(Number and Street) 'LED
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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