Homestead_Blankenship.,
SDFID:
-� . .".:. _._ _ _ _. _.yr;i�
Shannon S. Frank
_ P�epurero(NeSalesDisdosu�eFOrm
Address(Num6erond5tree[)
ritle
McCrav Frank 8 Klinaler
EiSECLER S '.GRANTOR S � _ , _ - =- :. ,. �_. � -_.` �_. . . �,--'�' � �- - ' -' � � � -.- - _ .
StanhPn M Blankench;n R.�dv V Rlankanch�n
Seller 1� A'ame as appears on ronve}nna documen[ Seller 2- Name as oppears on conve}nnce docvmm[
1770 Mrpowall Road
Addrus (Number and5treet)
Fvancvilla Indiana 4771?
Under penalties of perjury, I hereby cer[ify [ha[ [his Sales Disclosure, [o [he bes[ of my knowledge and belief, is true, correct
and compl� [e as required � la�v, at�d is prep�r�in accordance wi i IC 6-1.1-5.5 'R al Property Sales �sdosure Ac[".
�11_ �In // . // l
\'II.l.s�! w� � f l/! �. �CCG c 1L� Uv �,.v�
� Signa eof5eller SignamreofSe er
Bvyer 1- Name as appears on t'onveyanre dacumen[
Tk1E SALES DISCLOSURE FORM MAV 8E USED TO APPLY FOR CERTAIN DEOIICf10NS FOR TNIS
Q � 1. Will this property be the buyer's primary
residence? Provide complete address of F
residence, including county:
Address
Ciry.Smte ZIP Cade Counry
� Q 2. Does the buyer have a homestead in Indiana [o be
vaca[ed for this residence? Ifyes, provide
comple[e address of residence being vacated,
induding county:
Address (Number and SVeetJ
Ciry.5mtt21PCode Counry
Bvyer 2- Nome at appears on ronveyvnce dacument
Address (Number ond Stree[)
Ciry, Swu. and ZIP fode
Q � 3. Homestead
❑ �✓
� ❑�
� �
❑ ❑✓
APPLY �'� --
APPLY.
Heating/Cooling System
S. Wind Power Device
6. Hydroelec[ric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is [his property a residential rental property?
9. Would you like m receive tax sta[ements for this
property via e-mail? (Provide contact information
below. Please see instructions for more information.
Not available in all counties.)
G? �o-� 9- � �o/_rtxL/1 6 Ga �
h:morv mmnrrtv awner mnract name E-mail
Under penal[ies of perjury, I hereby certify [ha[ [his Sales Disclosure, [o [he best of my knowledge and belief, is true, correc[
and complete as required by law, and is pre ared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Ac[". (No[e:
Soouse infor�pation, Social Secgt'ity an�D�er's License/O[her numbers are no[ necessary if no Homestead Deduction is
af Buyerl
�
LastSdigitsofBuyer]Dnver's State LastSDigiGSO(Social5ecuntyNumber
License/1 D/Other Number
Signao�re a(Buyer2/Spovse
Namea(BUyer2/Spoux
Sign Date (MM/DD/YYYY)
Las[Sdigi[safBuyer2/SpouseDriver's Smte LastSDigiuo(Social5ecunry
Number License/lD/OrherNum6er