HomeMy WebLinkAboutHomestead_HeckerINDIANA SALES DISCLOSURE FORM
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Selfer 2- Name as oppmn am m�veyance da'vment
Addr¢t (NUmber and StreetJ
Ciry, Smte, and 21PCade
Under penalties of perjury, 1 hereby certify [hat this Sales Disclosure, to the best of my knowledge and belief, is [rue, corred
and c�ple[e as requir�ed by law, and is prepared in atwrdance with IC 6d1-S.S, "Real Property Sales Disclosure Act".
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and
TNE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIY
1'ES NO CO\OITIOY /
� 1. Will this property be the buyer's primary
residence? Provide complete address of primary
resi ce, induding cou
Gl`1U�1 S.�QA�w(�n ��rcle
?�`a�e's`+°�`-� �, �r� c� 3 � �, 6s �
Ciry, Sm[e ZIPCOde Counry
� �2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addrm(Numberand5vee[J
Ciry, Smre ZIPCode
Counry
SignamreofSeller
Bvyer 2- Name as appears m<onveYance da'umen[
Address (NUmber ond Sveet)
Ciry, Smte, and Z1PCode
IDEYTIFY ALL OF THOSEi1�AT APPLY.
3. Homestead
U . rgy eating/CoolingSys[em
� � 5. Wind Power Device
❑ � 6. Hydroelectric Power Device
❑ [/�- 7. Geo[hermal Energy Heating/Cooling Device
� � 8. Is this property a residential rental property?
� � 9. N'ould you like to receive tac statements for this
property via e-mai]? (Provide contact information
below. Please see instructions for more in%rmation.
Not available in all coundes.)
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himaryorooarryownerronmcmame E-mail
Under penalties of perjury, t hereby certify [ha[ this Sales Disclosure, to [he best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (NO[e:
Spouse informatlon, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduc[ion is
being filed.) n
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Signa[urc ofeuyer2/Spouse
PnntedLegalNameo(BUyer2/Spouse SignDa4(HH/OD/YYYY)
Las[Sdigi[sofBuyer2/SpouseDriveri Smte Los[SDigiuoj5onalSecunty
Num6er License/ID/OtherNum6er
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