Homestead_Smith (24) •
INDIANA SALES DISCLOSURE FORM SDF ID: 26 - 18 - 1121928 Page 2
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Jay O.Walden Attorney at Law
Preparer of the Sales Disclosure Form Title
202 E.North Street Law Office of Jay D.Walden
Address(Number and Street) - Company
Grayville, IL 62844 618-375-2611
City,State and ZIP Code jwalden@jaywaldenlEm
Telephone Number E-maill
E;SELLEIMGRANTOR(S)' ----
Jerry R.Smith --_ - � Kathryn Smith ------- ----
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10744 W.600 S. 10744 W. 600 S.
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
d mplete as req ed by la ,and is prepared in accordance with IC 1.1.5.5,"Real Property Sales Disclosure Act".
Bgtat� Girrr �ignTi i - 'Qp
Jerry R Smith - /p - 3/- is Kathryn Smith - /3/ Ijzr
Printed Name of Seller Slgn.DateywrflWF7Y21 Printed Name of Seller ���(((��' Sran
L E.BUYER(SJ f GRANTEE(S)- APPLICATION.EORPROP.ERTTY TAXDEDUCT,IONS_IDENTIaALL.ITEMS_THAT;AP, _ -
Ryan J.Smith Jacqueline N. Smith NO(/
Buyerl-Name as appears an conveyance document Buyer Name asel �VY
vyappearson conveyance document
10678 W. 600 S. 10678 W. 600 S. ,c. Z018
Address(Number and Street) Address(Number and Street) piss
YES NO CONDITION I YES NO CONDITION
® ❑ 1.Will this property be the buyer's primary m 0 3.Homestead
residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System
residence,including county:
10744 W.600 S. ❑ m 5.Wind Power Device
Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device
Owensville, IN 47665 26 ❑ ® 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
m El 2.Does the buyer have a homestead in Indiana to be El m 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ m 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.
10678 W.600 S. Not available in all counties.) ^rl 1
Address(Number and Street) ^1 � y'� �70Cr
Owensville, IN 47665 Gibson Ryan J. Smith r7l lP-\�-Vc--- co to 1.Ickc7—
City,State ZIP Code County