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Homestead_Jenkins (3)C19'.h'-�c:1=iJCc^e
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Under penalties of perj�u}•, 1 hereby certift• d�at this Sales Disclosure, to the best of m}•laioavledge and be�ief, is ime, correct
an oi e,C a�s� req�red /by`�la}`�f� nd is repared in accordance widi IC 6•1.1•S.i,�" al Property Sales Disdomre Ac['.
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iHE S1LES OIS[LONRE FORM PL1Y 8E lSED TO APPLY FOR [ERi.lL� DED[iCTI0Y5 FOR TNLS PROPERTI'. IDEVTiFS'.ILL OF SHOSE SFLii,IPPt]'.
1TS AO fAKDIIIOV YFS XD CO\DITIOA
�[ � i. FVili this proper.y be the buyer's prir.�ary
r residence? Procide complete address of prir.�an�
�/\� .f�idenc�ia[l.uling`�nh�: � %�_.
( 1 ( / /l L�� �L J
�� 2. Does the buyer have a homestead ia lndiaaa :o be
�aca:ed,"or &is residence? if c�es, oro��de
to:nplete address of residence being �acated,
includiag touah�:
ddc.-.•s I�Lmtir� er.d 5:-er.j
;. =:.�:�b. .. -
� � 3. Homes:ead
� 4. Solar Enera� Hea:ing/Cooling S}•ster.i
� 5. �tiind Po���er Device
� G Hydroelectric Power De�ice
� 7. Geoiherr.ial Energ�� Hearing/Cooling Device
� 8. Is this propem• a residentlal rental prope^q•?
� 9. �tioiild you like to receice ta.i stateme�ts for this
property cia e-tnail': (Proidde cmitact infarmavon
oeioiv. Pieese see instr.�ctior.s for rrore in(ormation
tiot m�ai7able in oll coun:ies.)
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Under penalties of perjun�, I herebq certify tha: this Sales Disclosure, to t6e best of my 6��owledge and belief, is trve, correct
ai�d complete as requii•ed b}� law, and is prepared in accordance a+�th IL 6-11-55, "Real Propertt• Sales Disclosure AcY. (Note:
Spoiise inforniatian, Sorial Sen�rih� and Driver's License/Other uu�nbers are not necessa�y if no Houiestead Deduction is
beingFiled.) �,,, /f /� �
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Lcs*.Scigi:;v(E.}�er �5ao:i:Dris^er� Sc:e L�:iD:y:^tfSocia?Ser.�rit:
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