Homestead_Slone� �
INUTANA SRLES DISCLOSURE FORM SDF ID: Pa e 2
;D?�P,REP.ARER� ��Ct'•�'".a?t8 y �.P .c�Y�-s'�('u'�`�a�.�?i�� ` ''.=`YF.�uff:�`_..."_.i �Z"�''-4��� -. �::�:r�.a'la.a�-���ri'�2Ft�"...�2�'rct'.�.�:'=:�,•a'-.�'� ;r5»v'"�:
a M. Drule Attornev No. 4759-26
eparer o/Ne Sala Disdosvre Fo(m Ti4e
OS N. Church Streei. P.O. Box 146 Law Office of Rav Drulev
AdEras[Numberand5tree[) Company
Fort Branch. IN 47648
tE�SELLER 5 ' GR.4NTOR S :3�.Z.�4.`�'��"��iat�>?'�'`—�;- ,7.' � .��`�: °x:�.c" ��"�`»° � .��.'a'.� 7�i-��`�'E : �. "<�-�:,`.
Harrod Development LLC
Seller]-Nameasappmnonconveyvnredacvment ShcerZ-Nomeasoppearsonronveynnced ument �
600 F. Strain !�
Addres (Number and Street) Addrea (NUmber and Stree[J
Fort Branr.h. IN 47fi4A
Ciry, Smte, and Z/P lade �(ry, Smte, and LP lode
Tele honeNUm6er E-mail Tele honeNUmber E�mail
Under penalties of perju , by certify that this Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and comQete�s requir aw, n's prep 'n accor ance wi[h IC 64.1-5.5, "Real Property Sales Disclosure Act".
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Sgnao�reo/Shcu � 5{gnamreo(Sel/er
k3aaod Development LLC 10126I2009
RintedNamea Seller Si nDa[e(XN D Pr(nmdNameo Sd/e� Si n0a[e(HN/OD
.'-E=BUYER S `.GR'ANTE =?AP,P,L'`[CATIONiF0R1P.ROP,ERT,YaTF1X�DEDUCTIONS:i1DENTI�A�'L?ITEMSYTHAT{AP,PLYw'';+= +t�"`�Sc_�.`.3`
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Buyrrl-Namemapymrsomm�• vncedocumen[ Buyer2-Nameasappearsomm�ve}vncedocvment
96E175S
4ddrm (Num6erand Stree[J Addrest (NUmber and Sbcet)
ncisco IN 47649
liry, Smte, and ZIPCode Ctty, Smre, and LP Cade
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E-mall Tele honeNUmber E-mail
THE SALFS DISCLOSURE FORM MAY BE I15ED TO APPLY FOR CERTAI\ DEDURIONS FOR THIS PROPERTY. IOEhTIFY ALL OF TNOSE THAT APPLY.
YFS NO CONDRIOY
Q � 1. Will [his property be the buyer's primary �✓ ❑ 3. Homestea
residence? Provide complete address of prima , ar Energy Heating/Cooling System
residence, including tounty:
q7 q 5 G � Q 5. Wind Power Device
Addras(NumberandSvcetJ ❑ Q 6. Hydroelectric Power Device
Fort Branch IN 47648 � Q 7. Geothermal Gnergy Hea[ing/Cooling Devicc
Ciry,5mu7J Code lounty
� � 2. Does the buyer have a homes[ead in Indiana to be � ❑`� 8� �s this property a residential rental property?
vaca[ed for [his residence? If yes, provide ❑ ❑✓ 9• �✓ould you like to receive tax statements for this
complete address of residence being vacated, property via e-mail? (Provide contact informadon
including county: 6elow. Please see ins[ructions for more informadon.
Not availa6le in all coundes.)
Addras (Numberand Sbee[)
��-�y ��o- oo-aao. j�sa-oa.T
Ciry, Smte Z/PCode Counry
Pomaryproperry owner ronmc[ name E-mvll
Under penalties of perjury, I hereby certify [ha[ this Sales Disdosure, [o the best of my knowledge and belief, is true, correct
and complete as required by nd is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse i o a[ion, Soc' ty and Driver's License/O[her numbers are not necessary if no Homestead Deduc[ioo is
being f d.
nvmr uyer7 � Sgnomreofeuyei2/Syouse
I ianna 1 Slnnr 10126/90(19
PnntedLegalNameo Bvyerl IgnDare(M.a/oD/YYYn PnnredLegalNamea(Buyer2/Spouse SignDote(wn/DD/YYre�
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Las[Sdigicso/Buye�]Onver's State LastSDigitso%SocialSerurityNumber Las[Sdigitsof8uye�2/SpouseDriver's Smte Las[SDigi[soJSacialSecuriry
License/!D/OtherNum6er Number Licente/ID/OfherNumbe�