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- Bushnell, William_3/31/2023 • SALES DISCLOSURE FORM
4, .i State Form 46021 (R14/1-23) SDF ID
et' �
• 1
,„ Prescribed by Department of Local Government Finance County Year Unique ID
r7 � Pursuant to IC 6-1.1-5.5
PRIVACY NOTICE:The telephone numbers and Social Security numbers of the parties on this form are confidential
(eie according to IC 6-1.1-5.5-3.Do NOT place personally identifiable information(e.g.consulate numbers,passport numbers;
government ID numbers,etc.)on this form as it may become publicly available.
NOTE:All questions must be answered to the best of the individual's ability.If the question does not apply,write"N/A"in the
space provided.If the information requested is unknown,leave the space provided blank.Failure to provide a response for the
italicized fields shall not result in the rejection of the underlying conveyance document by local officials.
INSTRUCTIONS:For additional information on how to complete this form,see the Sales Disclosure Form Instructions.
