HomeMy WebLinkAboutHomestead_CourtrightAddress(Nury'�qppjvyr}pLe SGnVIKS. LL�/
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`'rys�`�°° . . 3V166E, IN a77oS
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_SJ�RISTOPHER R COLLINS
Seller]-A'omeasa pearsonronveyanredacvment
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Add Numberand5vee)
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Ci[y Srure, and Z1PCode
Title
Componv
Tele honeNvmber E-mail
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Seller 2- Nome as appears am m�veynnce docvmen�
Addres (Nvmber and Svee[J
Ciry. Sm[e, and ZIP Code
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and coya,Qlete�as required bx law, and is prepared in accordance wi[h IC 641-5.5, "Real Property Sales Disdosure At[".
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THH SALES DISCLOSURE FORM MAY BH USED TO APPLY FOR CERTdI.�' DEDlIRlO\S FOR
�'vs rco m.mnon
� 1. N�ill chis property be [he buyer's primary
residence? Provide comple[e address of prima
����Feside�cg�cludi�� unty:
.ye�K ! �c� �/ �/ /f /
Adjs'sj(kumlVi l.L(�`LY l l/ V //�`('u (J �N��(// /
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Ciry.Sm�eZ1 ade Covnry
❑ 2. Does the buyer have a homestead in Indiana to be
� vacated for this residence? If yes, provide
complete address oF residence being vacated,
including counh�:
Address (Number und Svee[J
CiN.5mte2/PCode
Signamreof5eller
Pnn[ed Name o(Seller Sinn Da[e [MM/oD/YYYY�
IUCTIONS-'.'ID6NTIFYACL ITEMS:THATAPPLY�""�.:-r � '�' e <
Buyer I� A'ame as appenrs am m�vryonce dorumm[
Address (Nvm6e� and SveeQ
CiN Smre, and ZIP lode
7efephoneNUm6er E-mail
I�PROPERTY.�fOEhTIFi,RtO HOSETHATdPPLY.
Y KO CO\DITION
❑ 3. Homestead
��. •nergyHeating/CoolingSys[em
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� ►i�'
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5. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is this property a residential rental property?
9. Would you like to receive tae s[atements for [his
property via e-mail? (Provide ronmct informotion
6elow. Please see instructia�s for more informatian.
Not avai(a61e in all counties)
o?� - �9-i9_ ao �1- oo /. a��-�a �
Pnmarv nrocerN ownerronrac[ name E-mail
Under penalties of perjury, 1 hereby certif}� [ha[ [his Sales Discl�,to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC�-3'13:5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are no[ necessary if no Homestead Deduction is
being filed.) _ i• �--�
Signoture o/ Bvyer2/Syouse
Pnn[ed Legnl Nome o�Buyer 2/Spouse
Sign Dare (M.u/ODnI'n]
IDriver's e GastSDigitso�SocialSeeurityNum6er I LastSdigitto�Buper2/SpouseDriver's Smte Last50igiao�SaciolSecurity
n6er Number Lirense/(D/OrherNumber