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F <br />iA_ <br />SALES DISCLOSURE FORM <br />ney`1 4y <br />Stale Form46021 (RS11-06) <br />PRIVACY NOTICE: The telephone <br />form <br />7 ;= <br />numbers of the parties on this are 1111� <br />�III�P1111111111111111111�if���!; <br />Prescribed by Department of Local Government Finance <br />confidential according to IC 6-1.1-5.5- I <br />+, \ '.•.I� <br />raise• <br />Pursuant to IC 6-1.1.5,5 <br />3(d). <br />Part of Parry <br />Parcel Number(s) (Show additional parcels on separate sheet if necessary.) Acreage or Lot Size (spa <br />J_]8JJJJJJJJJJJJJJJJJJJ JJJJJJJ <br />LiJJJJJJJJJJJJJJJJJJJJJ JJJJ-_]JJ 0 <br />LJIJJ LIJ 'JJ J_UJJJJ0 <br />Address <br />d of Parcels <br />225 Donald Street <br />I <br />JJ <br />City, Town, or Post Office <br />State <br />ZIP Code <br />South Bend <br />JJ <br />AA_J6 314 <br />JJJ <br />Tax Billing Address (if other than property address) <br />City. Town, or Post Office Stale <br />ZIP Code <br />JJ <br />JJJJJ-JJJJ <br />Legal Description <br />Lot 1.55 of Bowman's 5th <br />Identify all conditions/items that apply <br />© 1-Buyer is an adjacent property owner <br />2-Vacant Land <br />O3-Exchange for other real property ('Trade") <br />O4-Seller Paid Points; amount If applicable <br />$ <br />F1 , ITT] <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 />OB-Personal property included In transfer; amount if applicable <br />$F]. J <br />O9- Significant physical changes to property between March 1 and date of sale <br />0 10- Non -Warranty deed; specify type Quit Claim <br />O11- Partial interest. Describe in special circumstances. <br />O12-Sacurity Inlarast documonts such as mortgages or trust doods. <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-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 />antirety. <br />O1 B-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 />Contract <br />JJDate <br />/ (MMID W /) Sales Price JJJ <br />Cescribe 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 />Ad <br />