Homestead_Smitha�INDIANA
KAREN HARBISON
Reparcr ofthe Safa Dittlosure Form
803 E STATE HWY 68
Addrcs (Numberand Sveet)
HAUBSTADTIN 47639
Ciry, Sma. and Z/PCode
• .IFRFMY NORMAN
Seller 1- Name as appears w tonveyona dacumenl
2�0 S MAIN ST
Addr� (Number and Svee[)
RRIFFIN IN 47616
Ciry, Smre. and Z1PCodr
Company
AN(;ELA NORMAN �
Sellerl-Nomeasappevrsanronveynncedatument I
290 S MAIN cT
Addrea (A'umber and Stree[J �
Ciry, Smre, and ZIP fude
E-mail
er penalties of perjury, I hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
of5eller
ar,aA w STATE RD 165
ACdr� (Nunbtr an d StrttlJ
OWENSVILLE IN 47665
Buyer 2� A'ame as oppears m t'onveyana documen[
Addres (Number and Sveer)
Ciry, Smtq and Z7P lode
TNE SALFS DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDURIONS FOR TNIS PROPERTY. IUENTIFY ALL OF THOSE TNAT APPLY.
YES NO COADITION
� ❑ 1. Will [his property be the buyer's primary C
residence? Provide complete address of primary
residence,including county:
10'�08 W 575 S _ _
Addrea(NUmberond5cee[J
OWENSVILLE IN 47665 GIBSON
Ciry.SmttZ/Plode Counry
❑ � 2. Does the buyer have a homestead in Indiana to be
vaca[ed for [his residence? If yes, provide
complete address of residence being vacated,
including county:
Addres (Number and 5treetJ �
Ory.SmrcZlPlade
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0
0
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0
3. Homestead �
4.Solar Energy Hea[ing/Cooling
5. Wind Power Devire
6. Hydroeledric Power Device
7. Geothermal Energy Heating/C
8. Is this property a residential r
9. Would you like ro receive Cax �
proper[y via e-mail? (Provide c
e Device
property?
nenCS for this
�t information
re information.
� Not availa6le in all counties�
�6 - /7 -69-lvo-Dal. �3I3-o �-
nam<
Under penalties of perjury, t hereby cer[i(y that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and wmple[e as required by law, and is prepared in accordance with IC 64.1-5.5, "Real Property Sales Disdosure Ac[". (Note:
Spouse informadon, Social Security and Driver's License/Other numbers are no[ necessary if no Homestea i Deduction is
beinQf� ��
� �
5{qnaoireof rl SignamreofBuyer2/Spause �
nen r.rv o ennlTHe 11I25I2015
PnnredLrgalNameofBvyerl 9gnDau[.rM/DD/YYnj PrinredLegalNomeo(Bvyo2/Spouse � SlgnDace(rr/OD/YYYY)
LastSdigitsofBuyer2/SpouseDnver's Sm[e LastiDigiaojSocialSecuriry
Liteue/ID/Othe�Number Number License/lD/OrherNumber