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' 30 Pe, Vs <br />r SALES DISCLOSURE FORM /�` f L o7 <br />s*� <br />\�= Slate Form 46021 (R516-05) PRIVACY NOTICE: The tell on' BUD/ ii <br />T fff s !! ttt J II <br />numbers of the parties on this' orm/ate/�I�� <br />� Presuibed by Department of Local Government r;nance I <br />' Pursuant to IC 6-1 1.5.5 confidential according <br />T-3(d). <br />ree _-- <br />Parcel Number(s) (Show additional Parcels ar rani <br />parcels on separate sheet it necessary.) Acreage or Lot Size (,p1; <br />1 181JJJ 6 IJJ�JJJJJJJ JJJ JJJJJJJ � <br />JJJJJ.JJJJJJJJJJJJJJJJJ JJJJJ � <br />JJJJJJJJJJJJJJJJJJJJJJ JJJJ-JJJ � <br />Address <br />p of Parcels <br />133 SOUTH LAUREL JJJ <br />City, Town, or Post Office State ZIP Code <br />50 J_ _J_J_ JJJJ <br />Tax BAlinq Address (if other than orooeriv address) <br />City, Town, or Post Office State ZIP Code <br />SOUTH BEND �]J - JJJJ <br />THE SOUTH 49.60 FEET OF LOT 10 AND THE SOUTH 49.60 FEET, EXCEPT 8 FEET ALONG THE WEST <br />Identify all conditions/items that apply NOTE: If items 12-21 apply, filers are not subject to disclosure <br />filing fee. <br />O1-Buyer is an adjacent property owner O 12-Security Interest documents such as mortgages or trust deeds <br />® 2-Vacant Land O 13-Leases less than 90 years <br />O 3-Exchange for other real property ("Trade") <br />O 14-Document resulting from foreclosure, or express <br />0 4-Seller Paid Points; amount If applicable threat of foreclosure, divorce court order, condemnation, <br />R <br />probate or other judicial proceedings. <br />O5-Change planned in the primary use of the property? Describe in O 15-Agreements and other documents for <br />special circumstances. <br />O6-Existence of family or business relationship between buyer and seller <br />O7- Land Contract Dated: <br />O8-Personal property included In transfer; amount If applicable <br />sF1 <br />O9- Significant physical changes to property between March 1 and date of sale <br />6 10- Non -Warranty deed; specify type QUIT CLAIM <br />O11- Partial Interest. Describe in special circumstances. <br />Contract Date (MWODA^NY) Sales Price <br />/12 <br />0 0 1 0 <br />mergers, consolidations, and incorporations <br />O16-quitclaim deeds not serving as a source of title <br />O17-Documents involving the partition of land between <br />tenants in common, joint tenants, or tenants by the <br />entirety. <br />® 18-Transfer to a charity, not -For -profit or government <br />institution <br />O19-Transfer for no or discounted consideration, or gift <br />O20-Rerecording to correct prior recorded document <br />O21-Easements, Right-of-way grants <br />Descnoe any unusual or specidi 611Gur115i01Hbtl5 leldleU 10 MIS 5a e. 11M U .1Ig L C Spec. ca .0n 0 Qnj - w= 0 Owners IP In <br />I <br />