Homestead_HigginsDISCLOSUREFORM SDFID:
Rav M. Drulev
heparer o(Ne Sala DSdmvre Form
505 N. Church Sireet PO Box 146
Addras (h'umber and StreeQ
FoR Branch IN 47648
Ciry.Smre, and2lPCode
Darrell V Manrk
Seller 1- Nome as appevrs on conv¢yonre documen[
_5136 950 W
Addras (NUm6er and Svee[J
�,vensville IN 47665
Ciry,Smte, mdZlPCOde
^ / "/' �►
r�:
Seller 2- Name as appmrs an canveyonm document
Addrms (Number and StreeQ
Ciry, Smte, and ZIP Code
Under penalties of perjury, 1 hereby certify [ha[ this Sales Disclosure, [o the best of my knowledge and
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales
.��..��� ,- - � �a�
Signamreo(Shcer � � ^ Signamreo(Selle�
Lonnie W Hiaains Sr
Buyer 1- Name as appears on ronvryonre documen[
5223 S 960 W
Addren (Number and SRee[)
Owensville. IN 47665
E-mail T 1 ph N
THE SALFS DISCLOSURE FORM MAY BE USED TO APPLY iOR CERTAI\ DEOURIOYS FOR THIS PROPERTY.
YFS NO CO\ORIOH
❑./ ❑ 1. Wi11 this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
_ 5?33 S 960 W
Address (Num6er ond StreetJ
Owensville IN 47665 Gibson
Ciry.SmreZlPCode Counry
❑ ❑✓ 2. Does [he buyer have a homestead in (ndiana to be
vacated for this residence? If yes, provide
complete address of residence being vaca[ed,
induding county:
Address (Numbe� and Strre[f
Ciry.SmleZlPCode Caunry
❑✓
❑
❑
❑
�
❑
❑
❑.�
�
❑✓
0
�
❑✓
�/
�CT
L\IIA
3. Homestead`�N�;xA
4. Solar Energy Heati�g�ii'q�g S�
S. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Co�
B. Is Chis property a residentlal rer
9. Would you like to receive ta�c st�
property via e-mail? (Provide ca
below. Please see instructions for
Not available in all counties.)
Under penalties of perjury, 1 hereby cer[ify [ha[ this Sales Disclosure, to the bes[ of my knowledge and belief,
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-S.S, "Real Proper[y Sales Disdc
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead 1
beingfiled.) � //
�/r.,'Ytn"�-�k Lc%� /Y� �.,�5 s�-
Signamrc af Bvyed Signo[ure o(Buyer2/Spause
1 nnniP W Higgins Sr n t ��Q 1015
Num6er License/ID/OtherNumber
E-mail
true, correct
ire Ac[".
�
�
e Device
proper[y?
�ents for [his
't information
re information.
E-mvil
true, correct
re Ad". (NOte:
duction is
Sign Date (MM/DO/YYY1�
o(SocialSecurity