Homestead_StevensINDIANA SALTS DISCLOSURE FORM SDF ID:
Page 2
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Ray M. Drulev Attorney No. 4759 -26
Preparer ofthe Sala Disclosure Forth Title
` 505 N. Church Street P.O Box 146 Law Office of Ray M. Druley
Address (Number and Street) Company
Fort Branch. IN 47648 (
City, State, and ZIP Code Telephone Number E -moll
t&SELLER S' GRANTORS Mn Fn.,
Billy D Stevens
Sellerl—�-^•^^^—_•= n conveyance document
Seller 2- Namem�� appears on conveyance document
Address (Number and Street)
O/{
Address (Number and Street)
City, State, and ZIPCode
City. State, and ZIP lode
(
E-mail
Telephone Number E -mail
Under penalties of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and;!7 let( as uired by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
SignatureofSel/er V Signature ofSeRer
V —Z1� —
Billy Q Stevens
Printed Name Sian Date HM D Printed Name o Seller Sign Date Mx D
?F�t6 S `.GRANTEE
_n — PCfC-ATION FOR'P.ROPERTY TAXII)
ONS? ID
ACL'ITEMS'THAT AP.P,LYt-s'Y`ts)x` l5, + ='"i
eel Goves
Carmen roves
Buyer l- Name as appeaso onveyance ment
Buyer- Nameas appea ronveyancedocument
6 n
and Street)
Address (Number and Street)
Oakland City, IN 47660
Oakland City, IN 47660
E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TH IS PIIOPER ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDTION
Q ❑ 1. Will this property be the buyer's primary
/ ❑ 3. Homestead
residence? Provide complete address of prima
/ ner ing /Cooling System
residence, including county:
5. Wind Power Device
.
630 W Division
�,
❑ [2 6. Hydroelectric Power Device
E] 7, Geothermal Energy Heating /Cooling Device
❑ 8. ro a 'al rental property?
Address (Number and Street)
Oakland City, IN Gibson
City, State Z1PCode County
❑ ❑✓ 2. Does the buyer have homestead in Indiana to be
a
vacated for this residence? If yes, provide
50otuld ell
❑ ou li [o receive [ax s en for [his
complete address of residence being vacated,
e- a . 'de nt ct information
including county:
a s' s o information.
Not available in all counties.)
�� -/ -/ 3a3- Ooo. a/0 cy?
Address (Number and Street)
City, Stare ZIPCode County
Primary propertyowner concoct name E -mail
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 -5.5, "Real Property Sales Disclosure Act ". (Note:
Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
being filed.)
�y
•nveA/ P 9'yl iliJ eti 39T VVI r (r^t�t
Signature of Buyer l // Signature ofBuyer2/Spouse
l rrnvps May 2h 9011 Carmen C o ,e May 2E 9n11
red
ense /ID /Other Number Number License /!D /Other Number