Homestead_Lewis (2) INDIANA SALES DISCLOSURE FORM - SDF ID: Page 2
[D�I;REPARERj, -- - . ^. - - - - ' '
C:Dean Higginbotham Attorney At Law
PreparerofthiSatDscaanre Farm Wile
208 E.State Street Higginbotham Law Office
Addict (Nimbi and Street) Company
Princeton,-IN 47670 812-386-3040 dean(@higglaw.net
City,State and VP Cole Telephone Number E-mail
WSELLER(SY/GRANTOR(S)'I - -_ - - -
Donna Jean Houchin r
Seller t-Name as appears on conveyance document Seller 2-Name asawears on conveyance document •
5643 River Walk Circle
. Address(Number and Street) Address(Number and Street) -
Under nalties of perjury,I hereby ce ifythat this Sales Disclosure,to the best of my knowledge and belief,is true,correct 1.
a and C �ete as r ired ,and prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
// i//,e il/. fit(
Sgnntum of Seller Signature of Seller •
Donna Jean Hour-bin /I%g-29/f .
Printed Naine ofSeller Sipe hate(M/DD/YYYY) Printed Name of Seller Sqn Date(NN/DD/Y17!)
kF?Bl-YER(S /GRANTEE(S�,-%APPCCATIONjEO.RIHRO$ERTYTAXOEDUCTIONSLIDE NFIEYdL LtTEMSITHATtAEELYC
s a
`
Gary Thomas Lewis.Jr.
evyer1-Name s on dotumen[ Buyer2-Name as appevn on coneo° Q e1JE Dconveyance
•• 5481.W.250 S. - ... -. .-"
,
Address and Street). Address(NumberandSnbet):. DEC'6 .201/
- Owensville.IN 47665 - -
' gra SALES' . n't.DISCLOSURE FORM MAY BE USED TO APPLY FOR[ERTAINOmnCr10N5 Sines PROPERTY:n)ECONDMON PLY. - - .
' YE- ' ' NO-'• CONDRION YES NO CO:YDrr10N
' ❑ 1.Will this property be the'buyer's.primary - . . • . :El:.-.❑ _ 3.,Homestead -
IZI residence? Provide complete address of primary . oar ne
residence;including county: ❑ '� 4-Sl E
rgY Heating/Cooling System •
5481 W250 S - `❑ •• 0 5.:Wind Power-Device-• -
Address(NumberundStml) ❑ • 0 6.Hydroelectric Power Device• - -
Owensville.IN 47665 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State 7JP Code' County .
❑ ELI 2.Does the buyer have a homestead in Indiana to be ❑ B.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ z 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..
Net available in all counties)
Addres(Number and Street) a49-I I-3q-co'-000:9 14_ oat
Gary Thomas Lewis:Jr. ..
Ciry,State ZIP Code . County
Primary propereyownamnmGname E-mail
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