Homestead_Dearing.r�.L"x�.,:. _ . _ _�' �s:�;«.. _.- . F_ _ -.. ..._
Addr�'(h 5 [ •
19 N. W. FOURTH ST.. STE 500
CIry,Srute ,
Compvny
Telephone
E:SELCER S GRANTOR S �,� �:,...- , °�-,_r ,,; �.,� : - - i r<: .; - � _ .�-. i.�. �., _ . - .
AARONJOST
Seller ]- Nome as appean on ronveyana dacumen[ Selier 2- Name as appears on rome�nnce drcument
l�� �Jo � ��f i
Addrea(A'umberand5tree[) � dddress(Numberand5treetJ
/�..bs��� ��v �7� 3�
E-mail
Under penalties of perjury, 1 hereby certify [ha[ this Sales Disdosure, to the best of my knowledge and belief, is true, wrrect
and complete-as`r2quir�tJ by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
Buver I � Nome
andZlP
THE SALES DISCLOSORE FORM MAY BE USEU TO APPLY FOR CERTdIN
�❑ 1. \Nill this proper[y be the buyer's primary
� (� I residenced? Provide complete address of primary
r,/��JI �i���e�,�I::;°��gcounty: �
�� 2. Does the buyer have a homestead in Indiana [o be
vaca[ed for [his residence? If yes, provide
complete address of residence being vacated,
including county:
Addreu (A'umber and5vee[)
Ciry.Smre
Counry
ITEh1S
euyer2-h'ameasappeorsan vevanredxument
S�;�L��1C.G�1'1 �
Addrett (A'vm6erand5vee[)
Fa�c�� `,�c,�����-, , -rN �1�C��18
APPLY.
Heating/Cooling System
� �� S. Wind Power Device
� d 6. Hydroelectric Power Device
I❑ d 7. Geo[hermal Energy Hea[ing/Cooling Device
� �Is [his property a residential rental proper[y?
. Would you like [o receive [ax statements for this
property via e-mail? (Provide conmct informotion
below. Please see instructions for more infarmaCion.
Not availoble in all counties.)
�'G -/9�4- /��- oo �. ,3,�2_ a�G
ronruc[name
E-mai/
Under penalties of perjury, 1 hereby certify that this Sales Disdosure, [o the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-11•5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deduction is
being filed.) ^
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Number
License/lD/O[her Number
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Number License/ID/OtherNumber