Homestead_WestPrepareroftheSalu Dicdasvre Farm Title
219 N. Hart St. PO Box 13 Hali. Partenheimer & Kinkie
'�ea (Number and So-ee[J Company
� ceton. IN 47670
City. Smre, and ZlP Code Telephone Number E-mail
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�aRP�� SRll�tl
Seller ]- Name as oppears on conveyance document
Addrea (Number and SveetJ
CTNensvilir IN 47fifi5
Ciry, Smte, ond ZIP Code
Se/!er 2� Name as appears on conveyance docvmen[
Address (Number and Street)
Ciry, Smte, and Z/P Cade
E-mail
Under penalties of perjury, l hereby cerbfy [hat this Sales Disclosure, [o [he 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 AcY'.
x �
Signomreof5eller� � � �
1-Name
E-mail
TNE SALFS DISLLOSURE FORM MAY BE USED TO APPLY iOR CERTAIY DEOUCfI0N5
Q� 1. Will this property be [he buyer's primary
residence? Provide complete address of F
residence, including county:
906o W. 400 S.
Address (Number ond Street)
Owensville IN 47665 Gibson
Ciry. Smte ZIP Lade Counry
✓� � 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vatated,
including county:
3699 Lisa Lane
Addres (Num6er and So-eetJ
Plainfield.IN 46168
City.SmteZlPCode Counry
Signamre ofSeller
Addrecs (Number and StreetJ
Plainfield.IN 46168
City,
Dare
�'�„A�
APPLY.
Heating/Cooling System
5. Wind Power Device
� ✓� 6. HydroelecMc Power Device
❑ ✓� 7. Geo[hermal Energy Heating/Cooling Device
� ✓� 8. Is this property a residentlal rental property?
� 0✓ 9. Would you like to receive tax statementr for this
property via e-mail? (Provide contact informotion
6elow. Please see instructions for more information.
Notavailable in all counties.)
Larry C& P�� J. � s�jOD' OD� G�oJ � O�
Pdmarvor0oer[vownerconmc[name Email
Under penalties of perjury, I hereby certify that this Sales Disdosure, 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/O[her numbers are not necessary if no Homestead Deduction is
being filed.)
�" ��,,I.,,�- � a -�� 1, �� �, �-
dre JBuyer] SignamreoJBuyer2/Spanse
1 arrv I WPCt _ Palda I WPC1
SocialSecurity
Lirense/ID/O[herNum6er Number License/ID/OtherNumber