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Homestead_Keil (4)INDIANA SALES DISCLOSURE FORDt
Dan L. Reeves
Preparer o([he Salu Disdosure Form
116 S. Main St.
'recs (Number and StreetJ
�nceton, IN 47670 �
City, Smtq md ZIP lode
Julia A. Meyer PR Fstate Ralnh Wonds
Seller 1- Name as appears an ronveyanre documen[
208 N Ar[pm Ct
Addres (Number and Street)
Huntingbura IN 475d2
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TiUe
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E-mail
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Seller 2- Name as appears on conveyance docvmen[
Address (Number and Street)
Ciry, Smre, and ZlP Lode
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
an/�d co/m�plete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
�IAX � �� 1 � IF.U//� �iRA�tswe.� •
naNre of5elfer Signa6�re ofSeller
e
Addrecs (Number and So-eetJ
THE SALFS DISCLOSURE FORN MAY BE USED TO APPLY FOR CERTAIY DEDURIOYS FOR THIS
✓� � 1. Will d�is property be the buyer's primary �
residence? Provide complete address of primary
residence, induding county:
��aF F ims �
Address (A'um6er and Stree[)
Haubstadt IN 47639 Gibson
City,SmteZl Code Counry
[J � 2. Does [he buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addrea (Number md StreetJ
City.Smce ZlP Code County
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I�
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❑✓
�✓
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EMS THAT APP.tiY.�.'
APPLY.
3. Homeste
4. Solar Energy Hearing/Cooling Sys[em
S. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is this property a residentlal rental property?
9. Would you like to receive tax statements for chis
property via e-mail? (Provide contoct informotion
6elow. Please see instructions for more information.
Notavailable in all counties.J
/� i I/ ii � —
nome
E-mail
Under penalties of perjury, 1 hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Drivec's License/Other numbers are not necessary if no Homestead Deduction is
bein filed.) � _
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oireofBuyerl g mreofBuyer2/Spa
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