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r <br />KaE ArSALES DISCLOSURE FORM <br />State Form46021 (R617-06) PRIVACY NOTICE: The telephone <br />numbers of the parties on this form are <br />f,I Prescribed by Department of Local Government Finance confidential according to IC 6-1.1-5.5- <br />I Ilflll llllllllll 1�111l1I1! llll!!I Ill �111 l�l1 <br />Pursuant to IC 6-1 1-5.5 <br />3(d). <br />r 016 - <br />Parcel Number(s) (Show additional parcels on separate sheet it necessary.) of Parca <br />necessary.) Acreage or Lot Size (spill, <br />J JJ1 J 1-JJJJJJJJJJJJJJJJ JJJ.Js� o <br />JJJJJJJJJJJJJJJJJJJJ JJJJ-JJJ o <br />JJJJJJJJJJJJJJJJJJJJJJJJ JJJJ-JJJ o <br />Address p or Parcels <br />J705 Howard Street I <br />City, Town, or Post ofrice Stara ZIP Codo <br />South Bend Jr3 AAAIl i _� J J J <br />Tax Billing Address (it other than property address) <br />803 L i nco 1 n,rruy West <br />City, Town, or Post Office <br />State <br />ZIP Code <br />South Bond <br />JP1 <br />JJJJ <br />JJJJ <br />Leqai Description <br />35 Ft Mid Pt Lot 82 Sorins 2nd Add <br />Identify all conditions/items that apply <br />O1-Buyer is an adjacent property owner <br />® 2-Vacant Land <br />O3-Exch3nge for other real property ('Trade") <br />O J4-Seller Paid Points; amount if applicable <br />mJ Jm <br />O5-Change planned in the primary use of the property? Describe In <br />special circumstances. <br />NOTE; If items 12-21 apply, filers are not subject to disclosure <br />filing fee- <br />O6-Existence of family or business relationship between buyer and seller <br />O7- Land Contract Dated: <br />O J 8-Personal property included in transfer; amount if applicable <br />JJJ JJ <br />O9- Significant physical changes to property between March 1 and date of sale <br />Q10- Non -Warranty deed; specify type Qu i_t C 1 a I rI - <br />011- Partial interest Describe in special circumstances. <br />O12-Socudty intarost documents such as mortgages or trust deeds. <br />O13-Leases less than 90 years <br />O14-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 />O16-Cuitclaim 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 />19-Transfer for no or discounted consideration, or gift <br />O20-Rerecording to correct prior recorded document <br />O21-Easements, Right-of-way grants <br />Contract Dale (MMIDD(YYYY) Sales Pnca <br />JJ/�1/ I i I $ <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 fi <br />kk <br />./ <br />