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Seller 2� Name os appears om m�veyance dacummr
Address (Nvmber ond Sore:J
Ciry. Smre, and Z1P Lode
Under penalties of perjury, I hereby cerdfy that this Sales Disclosure, to the best of my knowledge aad belief, is [rue, correct
and complece as required by law, and is prepared in accordance witY� IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Act".
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THE SALES DISCLOSURE FORM h7AY BE USEO T0,1PPL2' FOR CFATAI\' DEDURIONS FOR THIS PROPERTY. IDENfIFY ALL OF THOSE TR47 MPLI'.
❑ 1. Wiil this properry be the 6uyer's primary
residence? Provide complete address of primary
residence, includin; county:
.4ddrea (Number and Scee[)
Ciry, Sm¢ ZfP �oce Cour.ry
❑ �?. Does the buyer have a homestead in Indiana to be
vacated for this residence? if yes, provide
complete address of residence bein� vacated,
induding counry•:
Addres (Number vnd S�ee.)
Ciry, Smre LPCOde Countv
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❑ 3. Homesiead
[� 4. Solar Energy Heating/Coolieg System
[�j 5. Wind Power De�ice
� 6. HydroelecRic Power Device
f�� 7. Geothermal Ener�y Heatlng/Cooling De�ice
I�f 8. [s this property a residential renial property?
[�9. Would you like to receive �c s�tements for this
properry via e-mail? (Provide ronmct injormonon
below. Please see insa-ucdoru'/'or more informarion.
Not available in a!( counties.)
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Under penaltles of perjury, I hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in acrordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other oumbers are not neressary if no Homestead DeducYion is
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