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Under penalties of perjury, t hereby certify that [his Sales Disclosure, to the best of my knowledge and belief, is [rue, correct
and com�lete as required by law, and is prepared in acwrdance �vith IC 6-1.1-5.5, "Real Property Sales Disdosure Act".
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THE SALFS OISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAI\ pEDUR10Y5
1. Will this proper[y be the buyer's primary
residence? Provide complete address of E
residence, ind�ding county:
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Q 2. Does the buyer have a homestead in Indiana to be
vacated (or [his residence? If yes, provide
complete address of residence being vacated,
induding county:
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Addres (A'um6er and Sueet)
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i PROPERTY. IDEf:TIFY
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THAT APPLY.
Hea[ing/Cooling System
5. Wind Power Device
6. Hydroelectric Power Device
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� 7. Geothermal Energy Heating/Cooling Device
� 8. Is this property a residential rental proper[y?
� 9. Would you like [o receive tar statements for this
property via e-mail? (Provide contact information
6elow. Please see instructions for more informadon.
Not available in all rounties.)
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Under penalties of perjury, l hereby certify that this Sales Disclosure, [o the bes[ of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[". (No[e:
Spouse information, Social Security and Driver's License/Other numbe • are no[ necessary if no Homestead Deducdon is
being filed.)
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