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Homestead_Rexing (4)
• INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1794562 Page 2 I D.PREPARER Peggy A.Ralston Title Assistant Preparer of the Sales Disclosure Form Tide 3101 N.Green River Road Suite 130 Columbia Title.Inc. Address(Number andstrecQ Canvponc Evansville, IN 47715- 812-471-8563 pralston@columbiatitlegroup.com City.Stare.and ZIP Code Telephone N m ber E-mail E.SELLER(S)/GRANTOR(S) - _ _ __ ' • _, Danny L.Humphreys Jr. • Joyce A.Humphreys Seller I-Acme as appears an conveyance document Seller?-Name as appears on commode document P.O.Box 202 4201 W.275 S. Address(Number and Street/ Address/Number and Street Princeton,IN 47670- Owensville, IN 47665- ' Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and m lete as required y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". AI i t_jrq••, 9dafSelle - l r�// �'7 ' ii7->/L �J, no. 'seller l Yi I "- UIhr( ,_itic tphi:e c Jr le- I I-I / no. . A:i4,L ' c (.. arl••,N Nnm,•, S•tr• 4"-1M-"r•v onmvy' Vrt ,e•r rrh',.Ilr. v"e_rlese nnr•nn.,,Y, F.BUYER S /GRANTEE S -APPLICATION FOR PROPERTY TAX DEDUCTIONS-!IDENTIFY ALL ITEMS TH APPLY Stephen M.Rexing Buyer I-Name as appears on conveyance document Buyers-Name ea appears on conveyance document • 6860 S.County Road 165 Address(Number and Street) Address(Number and Siren) Owensville, IN 47665- DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT ..Flt 1L YES NO CONDITION ONDITION © ❑ 1.Will this property be the buyer's primary ( © ❑ 3. Homestead residence? Provide complete address of primary . 3 4.Solar Energy Heating/Cooling System residence,including county: S.Wind Power Device JIM_ -1 eT14 4261 W.COUNTY ROAD 275 5. ❑ Address(Number and Street) ❑ © 6. Hydroelectric Power Dev' e Owensville,IN 47665 GIBBON ❑ © 7.Geothermal Energy He ;ice Gry.Stare ZIP Code County ❑ ] 2. Does the buyer have a homestead in Indiana to be ❑ © 8.Is this property SiBSOkli�l T�SrA1 F.OR vacated for this residence? If yes,provide ❑ © 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. Not available in all counties.) Address(Number and Street) a(40 — II—a8 -/00 - Do/. a/7-oa ) Gat State ZIP Code Conan, Primary pmnern'owner contact name E-mail •