Homestead_LynnIOn1ANA SAI.R4 nySr1.nsuRF. FORM SDF ID: Paeg 2
�D_.-TNEPARER `" .m`4 "f' v31 b .��`u`3.?, fit_'. i_,t"' '`a'. -�` '0F4
Ray M. Druley Attomev No 4759.26
preparer ofthe Sales Dsclosure Form nue
05 N. Church Street. P.O. Box 146 Law Office of Ray M Druley
Address (Number and Street) Company
Fort Branch. IN 47648 (
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S °,GR4NLOR S : Yr, err Et
sfi:'SELLfER a r4
Janine. WPightman
Seller 1 - Name as appears an conveyance document
1708 Hollywood Ave.
Seller 2 - Name as appears on conveyance document
Address (Number and Street)
Fvnnsville IN 47719
Address (Number and Street)
Ciry, State, and ZIP Code
City, State, and ZIPCode
Telephone Number E -mail I
Telephone Number E -mail
Under penalties of perjury,) hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
an plete as required by law, a d is prepared in accordance with IC 6- 1.1.5.5, "Real Property Sales Disclosure Act ".
11 A A
Signo eofSeller S(gnaNreofSeller
d Name a Seller Si n Date (MMIDDAYM Printed Name o Seller Sin Date (MMIDDMM
`fF'ii TEES r AP, PL 'ICATION_F._OR ?P,ROP.ERTX3TAX+ DEDUCTIONS F7(ALli-ITEMS THAT"APPliXr7r- " I`
Rick Lynn
-Names nronveyan eumfat
l
Buyer 2- Name as appears on conveyance document
Adds (Numberand Street)
Address(Numberand Street)
:(ry,
E -mail
I Telephone Number E -mail
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION
❑✓ ❑ 1. Will this property be the buyer's primary
❑,/ 3
residence? Provide complete address of primary
❑ 4. Solar Energy Heating /Cooling System
residence, including county:
❑ ❑ S. Wind Power Device
904 c Division
❑ [Z] 6. Hydroelectric Power Device
Street)
Address (Number and
Francisco IN 47649 _ Gibson
❑ Q 7, Geothermal Energy Heating /Cooling Device
E] 0 8. Is this property a residential rental property?
city, StateU Code County
67
E) 2. Does the buyer have a homestead in Indiana to be
❑ 2] 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide
complete address of residence being vacated,
property via e-mail? (Provide contact information
below. Please see instructions for more information.
including county:
Not available in all counties.)
a�- 13- ao- lo3_000.oSa -o
Address (Number and Street)
City, State LP Code County
P E -mail
nmary properry owner ronmct name
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
".
and complete as required by law, and is prepared in accordance with IC 6- 1.1 -S.S, "Real Property Sales Disclosure Act (Note:
Spouse information, Social Security and Drivers License /Other numbers are not necessary if no Homestead Deduction is
V filed
natuurr,eofB1�\wyerg Signature o /BUyer21Spouse
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De.remher 7 2010
� Buyer I D/m'F) Panted Legal Name of Buyer 2 1Spouse Sign Date(MM/DDInyn
�Sianpate(�
Last S digits of Buyer l Driver's Last S Digits Number Last S digits ofBuyer2 /Spouse Driver's State Last S Digits ofSacml Security
License/10/0ther Number Number License/ID10ther Number