Laserfiche WebLink
rTF SALES DISCLOSURE FORM , <br />orc�; }`` slate Form 46021 (R419 04) PRIVACY NOTICE: The telephone <br />numbers of the parties on this form are II IIff !! II [[ !! !! II [[ ll [[ <br />�x Prescnbed by Depanmenlot Local GovemmenlFinancs confidential according to IC 6-1.1-5.5- <br />, <br />Pursuant to IC 6-1 1-5 5 <br />Leto <br />Part of Parcel <br />Parcel Number(s) (Show addlilonal parcels on separate sheet if necessary) Acreage or Lot Size Isplltl <br />JJ a 1 J °J �_.IJ.J ° �.�J..._J JJJJJ JJJJJ • �. <br />JJJJ_JJJJJJJJ._I_1_JJJJJ JJJJJ <br />JJJ_JJJJ JJJJJJ1_JJJJJJ JJ- JJJ } <br />Address a or Parcels <br />North side of Brick Road, 376.40 feet West of Orange Road/Quality Drive <br />City, Town. or Post Office _ State ZIP Code <br />� —i —J <br />SOUth Bend N 116 <br />—J_l JJJ JJ JJ <br />Tax Billing Address (if other than properly address) i <br />24334 W. Edison Road <br />City, Town, or Post Office uv� _ —_4 Stale ZIP Code <br />South Bend N� JJJJ JJJJ <br />Legal Description <br />See Attached Exhibit "A" <br />MENOMONEE <br />Identify all conditions/items that apply NOTE: If items 12-21 apply, filers are not subject to disclosure <br />;filing fee. , <br />• 1-Buyer Is an adjacent property owner <br />. 2-Vacant Land <br />3-Exchange for other real property ("Trade") <br />O4-Seller Paid Points; amount if applicable <br />$❑.=,JJJ <br />J5-Change planned In the primary use of the property? Describe In <br />special circumstances. <br />J6-Existence of family or business relationship between buyer and seller <br />J7- Land Contract Dated: <br />0 8-Personal property included In transfer; amount if applicable <br />J12-Sacurity Interest documents such as mortgages or trust deeds. <br />O13-Leases less than 90 years <br />. 14-Document resulting from foreclosure, or express <br />threat of foreclosure, divorce court order, condemnation, <br />probate or other judicial proceedings. <br />O15-Agreements and other documents for <br />mergers, consolidations, and incorporations <br />J18-puitclalm deeds not serving as a source of tilfe <br />0 17-Documents Involving the partition of land between <br />tenants in common, joint tenants, or tenants by the <br />entirely. <br />18-Transfer to a charity, not -for -profit or government <br />���JJJJ institution <br />9- Significant physical changes to property between March 1 and date of sale J 19-Transfer for no or discounted ronsideratlon, or gift <br />i <br />J 10- Non -Warranty deed; specify type O 20-Rerecording to correct prior recorded document <br />11- Partial interest- Describe In special circumstances. J 21-Easements, Right-of-way grants <br />Contract Date (MMlDD(YYYY) Sales Price <br />/ t.pc- 1 ► 1' = 0 $ I� 7 1_5 1 0 <br />Describe any unusual or special circumstances related to this sale, including the specification of any less -than -complete ownership interest and terms of seller financing. <br />JFee Simple Right -of --Way for Road Construction � <br />f <br />i <br />A <br />