Homestead_WallsIYDIA\ASALESDISCLOSURE FOR\1 SDFID SDOID 733367 page?
Ti. PREPAI2ER
Patricia A. McDonald Post Closing
PrepnmroJthe Saler Disclosvre Form Title
� S.E. MLK Jr. Blvd. Southwestem Indiana Land Ttle Inc.
. ...'idrea(NumbefandStreetJ . Company � , ... . .. . . . . .. . .
Evansville, IN 47713
£: SELCER S GRANTOR S ' -
RoyA. Hensley Peggy L. Hensley
SeIler I- Name as oppears on mrrveyunce dxument Seller2 - Name ¢s apprors on convryanre docummt
106 E. VJalnut Street 106 E. VJalnut Street
Addrets (Num6erand SoeetJ Address (NUmber and Sveet)
Owensville, IN 47665 Owensville, IN 47665-
Cil:Smte, ondZfPCade Ciq:Smte, undZlPCOde
E-maii
Under penalties of perjury, t hereby certify tha[ this Sales Disclosure, to the best of my� knowledge a�d be►ief, is true, correct
and complet as required by law, and is prepared in accordance with IC 6-1.1-5.5 "Real Property Sales Disclosure Act".
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ER S GEUINTEE -.AP.PLICATION!FOR P,ROPERTY:TAX'D - ALL ITEMS'THAT AP.P.tiY
Eric Walls Dana L. Walls
Bvyer]-Nameosap , mnveyvncedxumen[ Buyer2-Nameasa onveyancedncument
tate Road 765 7802 W. State Road 165
Address (Numberand Svect) Address (Numberand StreetJ
Owensville, IN 47665 Owensville, IN 47665
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E-mail Tele honeNumber E-maif
TNE SALES DISCLOSURE FORM hWY BE USED TO APPLY FOR CERTAIN DEDUCfI0N5 FOR THIS PROPERTY. IDENTIFYALL OFl}IOSE TNAT APPLY.
YES NO CO�DITION I YES NO CONDITION
Qx � 1. Will this property be the buyer's primary Qx ❑ 3. Homestead
residence? Provide comple[e address oPprimary � � 4. Solar Ener� Heating/Cooling System
residence, including county: � �
7802 W. STATE ROAD 165 S. Wind Power Device
Addras(NumberandSVee[) ❑ Q 6. Hydroelectric Power Device
Owensville, IN 47665 GIBSON � � 7. Geothermal Ener�� Heating/Cooling Device
Ci9:5mteZlPGode Lounry� °
XQ ❑ 2. Does ihe buyer have a homestead in Indiana to be � � 8� Is this property a residential rental property?
vacated for [his residence? If yes, provide ❑ � 9� �Nould you like ro receive tax sta[ements for this
comple[e address of residence being vacated, propert}'via e-mail? (Provide contaci information
including county: below. Please see insdvctions for more informadon.
104 N. 3RD STREET Not availa6/e in all caundes.)
Address(NumberandStree[J l � ' /
Owensville. IN 47665 GIBSON // a °`-�
Llry•.Sm:eZlPlode Covnry• �� ^ /�'^ �aO' ���• �
Rimarv prooerry owner cmmc[ name E-mail
Under penaltles of perjury, 1 hereby certify [hat this Sales Disdosure, [o the bes[ of my knowledge and belief, is [rue, cortec[
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 Driver's License/O[her numbers are noY necessary if no Homestead Deduction is
being filed.) j �// /� �({�
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