Homestead_Wahl INVIANR SALW UIM-LUSUKC •UKM Mit ID: rage"L
-D:P,REP,ARER ' "Y"
Richard Howenstine Closer
Prepsrer of the Sales Disclosure Form Tide
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3850 Priority Way S Drive Nations Title Agency
Address(Number and Street) Company '
Indianapolis, Indiana 46240 317-587-0440 rhowenstine(@nationstitle.com
City,Stare,and ZIP Code Telephone Number E-mail
E:SELLERISWGRA4$fOR(S)a ` naistT arigi `a ,± _?.>°`an ?"-- 3'- _a x t.. :
Danny P Miller
Seller 1-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
2CAg4 5. 'ZC L✓
Address(Number and Street) Address(Number and Street)
ut-u-Cn5✓,')j-e
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and�omplete as require t i' r `.aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Cull 110 _I •
Sgramre yeller Signature of Seller
Danny P Miller 4-7-2017
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAGIBSON COUNTY AUDITOR
YES NO CONDITION I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary [f ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: [1 ❑✓ 5.Wind Power Device
7944 S 825 W
Address(Number and Street) - ❑ (71 6.Hydroelectric Power Device
Owensville, Indiana 47665 - Gibson rl VI 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El 2. Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property?
vacated for this residence? If yes, provide ❑ @I 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.)
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Address(Number and Street)
d(o -ten -alp - lna-tnl . l-10 -O (
City,State ZIP Code County
Primary property owner contact name Email