Homestead_Harpe (3)Prepare�o(Ne Sales Disdosvre Form
19
ury, smre, a�a
SDFID:
Company
TefephoneNum6er
E-mail
JENNIFER L RLITTFR WRIGHT
Seller 1- Name as appears on mmeyonre documen[ Se/1¢r 2- Name as appears m mnvryance dacument
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Addr¢s (Numberand Stree[) Addrea (Number and StreetJ
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City.Smte, andZlPCode Liry, Smre, and ZIP lode
E-mail Tele honeNumber E-mail
Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complqte as requ� by law, and is prepared in accordance wi[h IC 6-11-5.5, "Real Proper[y Sales Disclosure Act".
1-NOmeasappean
Smte,andZlPlade -
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIY
Q❑ 1. Will this property be the buyer's prin�
residence? Provide complete address o a
Gr sidenc��dyding county:
�Nf f�y�n �'
/ J�(/�l{�U.//vee7 // v T(�/YO l�i� _ /I I
Ciry, Smte ZIP Code Lounry
� � 2. Does [he buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vaca[ed,
including county:
Addres (Num6er and Sveet)
Ciry.StareZlPCade lavnry
Signaareo(Seller
Buyer2-Nameas
Addres (Num6er and Sveet)
r�1.�ra�cF. , SN, �f'7 �Y�'
Ciry, Srare, and ZIP Code
�$ %
APPLY.
3. Homestead
4. Solar Energy
� � 6. Hydroelectric Power Device
❑ � 7. Geothermal Energy Heatlng/Cooling Device
� � 8. Is this properry a residen[ial rental property?
� � 9. Would you like to receive tar statements for [his
property via e-mail? (Provide rontoct informotion
belmv. Please see instructions for mare information.
Not available in all counaes.)
��-/9-/� 3Q3-�•.s.� Oa6
c.�mn..�n..�narrvnwno.�nnrnrrnnme E-mail
Under penaltles of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is [rue, correc[
and complete as required by law, and is prepared in accordance wi[h IC 64.1-5.5, "Real Property Sales Disclosure Ac[". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Dedudion is
being filed.) '/ /1 �J /
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Signamreo(BUyer] � ,_ 5(qnamreofBuyer2/Spovu
e i�-
Sign DOte (MM/a0/YY1'1')
LastSdigi[safBuyer7Driver's Sm[e LastSDigitsofSocial5ecurityNumber
License/ID/Other ,Vum6er
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PrinredLegalNameofBuyer2�'pouse SignDafe(HM/DD/YYI'YJ
LasiSdigitro%Buyer2/SpouseDriver's Smte Las[SDigi[to�SociolSecunty
Num6er License/lD/OtherNum6er