Homestead_Ravellette (3)INDIANA SALES
J. Roberf9(inkle
Preporero(the Sofu Dittlosvre Form
�9 N. Hart SL. PO Box 13
dres (Number ond 5[ree!)
nncetan IN 47670
Ciry, Smte, ond ZIP Code
E.
Seller 1� Nome as appearsom m�vrynnce documen[
�amN isow
Address (Number and 5[reetJ
Ciry; Sta[e,
�
SDF ID:
Hall. Partenheimer & Kinkle
Compony
E-mail
Seller Z- Nome as oppearson conveyance document
Address(Numberoid 5treet)
Ciry, Stare, ond ZIP fade
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and co1m///^'/1'/eie as required �byA law and is.pr p d in accordance wi[h IC 6-1.1-S.S, "Real Property Sales Disclosure AcY'.
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�gnaNreojSeller —� Signamreof5eller
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CERTAIN DEDUCfI0N5 FOR THIS PROPERTY. IDENfIF1' ALL OF THOSE THAT APPLY.
Q� 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
Addrts (Numbrroid 5[tret)
Monroe Citv IN 47557 Gibson
Ciry, Slate ZIP fnde Lounp•
Q� 2. Does the buyer have a homes[ead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including counry:
9151 Flathead Lane
Addres (Number and 5[reet)
Monroe Ciry IN 47557 Knox
Ciry, Smte ZIP fode Counry
YES NO [ONDITION
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3. Homestead
4. Solar Energy Heating/Cooling System
S. Wind Power Device
6. Hydroelectric Power Device
7. Geo[hermal Energy Heating/Cooling Device
8. fs [his property a residential rental property?
9. Would you like [o receive tax statements for this
properry via e-mail? (Provide conmct information
below. Please see instructions for more information.
No[ available in all counties.)
a►�-�� 354�� �5i-��a�
Eddie W. 8 Emma B. Ravellette
E-mail
Under penalties of perjury, l hereby certify tha[ this Sales Disclosure, to the bes[ of my knowledge and betief, is trve, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disdosure Act". (Note:
Spouse information, Social Securi and Drive�'s License/Other numbers are not necessary if no Homestead Deducdon is
bei filed.)
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iNreofB�yerl SignatureafBuyer2/Spoure
Fddie W Ravellette
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Las[ S digiu o�Buyer 7 Onver's S o[e Last 5 DigiGS af 5ocial Securi Number
Lirense/ID/O[her Num6er
Fmma B RavPllette
Secunry
Num6er License/ID/O[herNum6er