Homestead_KramerPreparer of Ne Sala Disdosure Farm
rme
• ���,����19 N�NI�"FOURTH ST.. STE 50U `°'��°°y
Ciry,Sm[G � TelephoneNumber,� , _ „ , _ E-mail
Under penal[ies of
and Comple[e as ve
Q/Seller
Buyer ]- Name as appears on
30 3 �t/, _
E-mail
Seller 2- Name as appeurs am m�veyance Aocvmenr
Addras(Numberand5treef)
Ciry, Sml4 and7JPCade
�, I hereby certify that this Sales Disclosure, to [he best of my knowledge and belief, is true, correct
by,law, �nd,is prgpared in accordance with IC 6•1.1-S.S, "Real Property Sales Disclosure Act".
Y�
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR
�� 1. Will this proper[y be [he buyer's primary
residence? Provide complete address of p' ary
residen e, including county:
'7U� EpSi ��l��'�A�2 ST
Addres (M1'umber and Svee[J
r=-1 I�2A�Je� if�J �-76�s1 -//3.Sc�i�J
Gry, ute P[ode Comry
�� 2. Does [he buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addras (Num6er and SveetJ
Ciry, SmreZlPCOde Counry
5{qnaNr¢
THAT APPLY �
Bvyrs I- Name as appeors on conveyonce document
Address (Number and StreeQ
Ciry, Smt4 a�d ZIPCode
IDEMIFY ALL OF
� 3. Homestead
Q' 4. Solar Energy Hea[i ooling Sys[em
❑ � 6. Hydroelectric Power Device
❑ l� 7. Geothermal Energy Heating/Cooling Device
❑ � Is this property a residen[ial rental property?
❑[�9. Would you like to receive tax statemen[s for this
property via e-mail? (Provide con[ott information
6elow. Please see instructlons for more information.
Not available in all munties.)
0?6-/9-i?-.3a�_Goo. /5�-a�(o
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best 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 Disdosure Ac[". (No[e:
Spouse informa[ion, Social Security and Drivers License/Other numbers are not necessary if no Homestead Deduc[ion is
being filed.) /J� � /'
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Si naNreo(BUyerl S{gnamreaJBuyer2/Spouse
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Pnn[edLegalNameo/BUyer2/Spouse S{gnDate(MM/DD/YYYY)
LastSdigiuo%BuyerlDnver's S[ate LastSDigi[ LastSdigiGSO(Buyer2/SpouseDriver's Srnte L¢st50igicso%Social5ecunry
License/ID/OtAerNumber Number Lireue/!D/OtherNum6er