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r <br />SALES DISCLOSURE FORM <br />SHE -' <br />ors. .t.rFs Slate Formae021 (R617-06) PRIVACY NOTICE: The telephone <br />conf nums of berntthe parties <br />according tonIC 61f1-5,5 re lit111�llllilNlllllll11I il�lllllff llll�ll <br />N, iX Prescnbed by Depanment of Local Government Finance <br />Pursuant to IC 0-1.1.5.5 <br />3(d). <br />• Baia - <br />Part o Paro <br />Parcel Number(s) (Show addiitonaf parcels on separate sheet if necessary.) Acreage <br />JJJJJJJJJJ or Lot ize (eplJJJJJJJJ�JJ—WJL4J) <br />o <br />JJJJJ___1JJJJJJJJJJJJJJ JJJJJJ � <br />JssJJJ.JJJJJJJJ___IJJJJJJJ JJParcels <br />225 Donald Street J-1 i <br />City, Town, or Post Office Slate ZIP Cape <br />South Bend JN J_ 6J_JJ JJJ <br />Tax Billing Address (if ocher than properly address) <br />City, Town, or Post Office Slate ZIP Code <br />JJ A_JJA I - J I J ___J <br />Lot 155 of Bowman's 5th <br />Identify all conditions/items that apply <br />© 1-Buyer is an adjacent property owner <br />2-Vacant Land <br />0 3-Exchange for other real property ("Trade") <br />0 4-Seller Paid Points; amount if applicable <br />s FT <br />JJ J <br />0 5-Change planned in the primary use of the property? Describe in <br />special circumstances. <br />0 6-Exislence of family or business relationship between buyer and seller <br />J7- Land Contract Dated: <br />0 B-Personal property included in transfer; amount if applicable <br />NOUN-0-mum <br />NOTE: If items 12-21 apply, filers are not subject to disclosure <br />filinq fee. <br />0 9- Significant physical changes to property between March 1 and date of sale <br />0 10- Non -Warranty deed; specify type Quit Claim <br />0 11- Partial interest. Describe in special circumstances. <br />0 12-Socunty Intorosl documants such as mortgages or trust daods. <br />0 13-Leases less than 90 years <br />J14-Document resulting from foreclosure, or express <br />threat of foreclosure, divorce court order, condemnation, <br />probate or other judicial proceedings. <br />J15-Agreements and other documents for <br />mergers, consolidations, and incorporations <br />0 16-Quitclaim deeds not serving as a source of title <br />0 17-Documents involving the partition of land between <br />tenants in common, joint tenants, or tenants by the <br />androty. <br />0 13-7ransfer to a charity, not -for -profit or government <br />institution <br />0.19-Transfer for no or discounted consideration, or gift <br />0 20-Rerecording to correct prior recorded document <br />0 21-Easements, Right-of-way grants <br />Contract Date (MMlDONYYY) Sales Price <br />m/JJJ / n o FFJ JJJ <br />Describe any unusual or special circumstances related to this sale, Including the specification of any less-Ihan-compfele ownership Interest and terms of seller financing. <br />