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e �r�rE SALES DISCLOSURE FORM <br />�k r Slate Form 45021 (R&7-06) PRIVACY NOTICE: The telephonenumbers +I IJ f i f f IJ I f <br />r _ '�a confidential la cord ng to IC 6-1.1rties on this r5 5 re I��I� IIJIII ��III ���III�II�II��J��lil ��I�lll� <br />NI 1= Prescrioed by Department of Local Government Finance <br />- Pursuant la iC 6.1.1.5.5 3(d)- <br />re`ie <br />r r <br />Pan of Parci <br />rParcelumber(s) (Show additional parcels on separate sheet d necessary) Acreage or Lot Size (spll <br />JJJJJJJJJJJJJJJJJ JJ_J�JJJ <br />JJJJJJJJJJ�JJJ�JJJJ_'JJJJJ J_]_J_J_J_J_' 0 <br />_'JJJJJJ�JJJJJJJJJJJJJJJ_U J-1-i-Lili 0 <br />Address <br />k of Parcels <br />225 Donald Street <br />JJJ <br />City, Town, or Post Office <br />Stale <br />Z€P Code <br />South Bend <br />JJ <br />JJJJJ <br />- J <br />Tax Billing Address (if other than properly address) <br />City. Town, or Post Office State <br />ZfP Code <br />L — — I J <br />JJJJJ-JJJJ <br />Leqaf Descnption <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 />$ F7 , <br />O5-Change planned in the primary use of the property? Describe in <br />special circumstances. <br />O6-Existence of family or business relationship between buyer and seller <br />O7- Land Contract Dated: <br />0 6-Personal property included in transfer; amount if applicable <br />1310MMM MEN <br />NOTE: If items 12-21 apply, filers are not subject to disclosure <br />filinq fee. <br />O9- Significant physical changes to property between March 1 and dale of sale <br />10- Non -Warranty deed; specify type Quit Claim <br />O11- Partial interest. Describe in special circumstances. <br />O12-Sucudty Interest documents such as mortgages or trust doeds. <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 otherjudlcial proceedings. <br />O15-Agroements and other documents for <br />mergers, consolidallons, 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 />O16-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 Date (1JM/DDNYYY) Sales Pnce <br />I / I I I 11 <br />$ <br />Describe any unusual or special circumstances related to [his sale, including the specification of any less -than -complete ownership interest and terms of seller financing. <br />