Homestead_GilpatrickINDIANA SALES DISCLOSURE
Ciry, Smtq anALP Lade
5e0v 1
-,+,":
F�'+��i^u. .�..�;_'
$U/V�-�
i
A lrm Numbvcnd5
,5 rGand�
�/%-/� / -
Onder penalties of perjury, 1 hereby certify that this Sales Disdosure, to the best of my Irnowledge and belief, is trve, correc[
and complete as requir� by �w, and is prepared iu accordance �+�th IC„fi;l.l-S,S, "$e�al Pyeperty Sales Disdosure Act".
iI
eppmrs on ronvrycna docummt
Adcrm
Clry, Smtq and ZIPCode
THE SAI.F_S DISCLOSIIRE FORM MAY BE USEII TO APPL1' FOR �RTAIIv DEDIICflONS FOR THIS PROPERTY. IDE,ITIFY ALL OF TNOSE TNAT APPLY.
[[� ❑ 1. Will this property be the buyer's primary
residence? Provide complete address of primary
%yO,(p/ �[,9-e.��"n�+�+`c�'eG�
i�'��(I,✓/L�I� � y
� � �'Y�G � ��h�� r
Ci.y, Sma ]lPCode Counry
❑ I,_,'✓2. Does the buyer have a homesiead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vawted,
including counry:
AC?ras (Numbv and StrmtJ
Ciry. Sm¢ IIP [ode
GI
�
■
�
■
�
�
❑
�
a�
�
�
�
�
3. Homestead
4. Solar Energy Heatlng/Cooling Sys[em
S. Wind Power Device
6. Hydroelectric Power Device
7. Geochermal Energy Heating/Cooling Device
8. [s this property a residential rental property?
9. Would you like to receive ta�c statements for this
property via e-mail? (Provide conmct informa7on
6elaw. Please see instructlonsfar mare informatlon.
Not availa6le in al/ muntlu.J
ownvcnnmc[
E-mail
Under penalties of perjury, I hereb}' certify that this Sales Disclosure, to [he best of my lmowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance �vith IC 6-1.1-S.S, "Real Property Sales Disdosure Act". (Yote:
Spouse inforniation, Social S urii,y and Driver's License/Other numbers are uot necessary if no Homestead Deduction is
being filed.) /' (� -
/ . �// _' . , , . � a�i 9-�� -3oa-000 o� s-o��
si;,am��o/suyu� n �� siy�emRO/avyUZ/s�u��
Po'n[edLegalNvmeo/BvyQ2/Spovse SignDale(MM/�D/YYYt]
Las[Sdigi[sojBuyerlDriver's Sln4 Las[SDigi[sof5ana15ecvriryNum6er I LastSdigiGtofBuyer2/SpouseDriver's Smte Las[SDigitsof5ocialS=curiry
Lirense/ID/O[herNum6er Num6er License/lD/OfherNumber