Homestead_Hasenour (6)\
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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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• Lisa A. Moody Attorney at Law
Preponr o/�he Safet Ditdosure Form T[le
215 W. State Street
AdErest(Number andSvmQ
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CE:�SSliL''ER�•S'.GR%IINiTORS.>w�.'��.�-,...,.�ai,':4i�4 a [�.�i't;,-ta,45_,:�4a?�.e:;r?r:1'�°'ASYS�H;.,. .,:.�:+.'e=�-'x ,ta-,<�;� .r,,,3 �-- �..
Richard 0. Hasenour Paul E. Hasenour
Seller I� Name m aypmrs on �onv<yanre dorvmenr Seller 1- Name ae appeara m conveyance dotumen[
'� �9�SS 3S'O/N 858 Timber Hills Drive
Addrrsr (Number and5c�ee[) Addren (Number and S�reeQ
Fort Branch, IN 47648 Freeport, IL 61032
Clry. Sta:e. and ZIP Codt .
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Under penal[ies af perjury, 1 hereby cer[ify [ha[ [his Sales Disdosure, to the bes[ of my knotvledge and belief, is [rue, correct
and comple[e as required by law, and is prepared in accordance w�[ 6•1.1-5.5, "Real Property Sales Disclosure Ac[".
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Sigmmrc oJ d!n Sig mre o/Sel(er
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Pnn[rd,YOmro Seqer Sion Da<e MM/DD Printed Name o Seller Si n Da4 �MM/Onp'Yv
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?F; �U.YER S •,GR�ANTEE 5 ;=.ttFfPGIGATION�FORiDEDU�tTION$�`AND`
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THE SALES UISCLOSORE PoRM OIAY 9E USEU TO APPLY FOR CERTAIV DEDURIOYS FOR THIS PROPERTY. IDENTIiY ALL OF Tf10SE TNAT APPLY.
YES NO CONOITIOY ' YES NO CONOITION
� ❑ 1. lNili this property be the buyer's primary �❑ 3. Homestead
residence? Provide comple[e address of primary � � 4, Solar Energy Heating/Cooling System
� residence, including county: � �S. Wind Power Device
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qddrut('um6erand5trttt) ❑ �6.HydroelectricPowerDevice
ic�'r� ��fc��.�c� ZN �1 �o �cb � ��S°`�` � �/7, Geothermal Energy Heating/Cooling Device
❑ry,Sm[e21PCOdr � Counry
� �2. Does the buyer have a homestead to be vacated for � �8• �s this property a residential rental property?
this residence? Ifyes, provide comptete address of
residence vacating, induding county:
Addren (NUmber andSVeel)
Orv, S[a:e ZIPCode Countv
Under penal[ies of perjury, 1 hereby cer[ify that this Sales Distlosure, [o [he bes[ o( my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance w' 6- 1•5.5, "¢e r erty Sales Disdosure Act".
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Signaturz o(Buyer] Signamre o(B r?
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