Homestead_Curl (2) /
INDIANASALES DISCLOSURE FORM SDFID: Paget
€A PREPARFR it . t _ : is7-v _.: s _ ._ ` i ''''.
Tiffany Hoon Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
City,State,and ZIP Code Telephone Number E-mail
William A. Folsom . Linda L.Folsom
Seller I-Name as appain on conveyance document Seller 1-Name as appears on conveyance document
4195 S 700 W 4195 S 700 W
Address(Number and Street) Address(Number and Street)
Owensville,IN 47665 Owensville, IN 47665
scare ana Lie Laze stare ana LIP core
Telephone Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
aqd compl�et�e as requigGd byland is prepared in accordance with IC 1-5.5,"Real P o� erty Sales Disclosure Act".
Signature of Seller �jr I cure of Seller
William A. Folsom al- 0019 Linda L.Folsom �n��2a/y
Printed Name ofSeller Sign te( M/OD/YYYY) Printed Name of Seller Sign ate(MM/DO/YYYYJ
kF E11(Sl`/GRARTEE(S113AP.P.L'IL;A7!It)NIFOR)BROP.BR•'t15;91'AXfDEDUC-TIONSNIDENTIEYIALL1PFSty`I547111ATiAP.PfiY
Jeremy R.Cur Dana Curl
a appears on conveyance document Buyer 2-Name as appears an conveyance document
9 S SR 165 79999 S SR 165
Address(Number and Street) Address(Number and Street)
Owensville,IN 47665 Owensville,IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS TY. IDENTIFYALL-OF-THOSE\PLY. FILED
YES NO CONDITION YES NO CONDITION
[Er 0 1.Will this property be the buyer's primary El3.Homestead Jun 18 2019
residence? Provide complete address of primary eating/Cool_
residence,including county: ❑ p 5.Wind Power Device GIBSON COUNTY AUDITOR CB
4336 S 700 W
Address(Number and Street) ❑ IZ 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ IZ z 7.Geothermal Energy Heating/Cooling Device
ary smteZIPCode County ❑ 10 8.Is this property a residential rental property?
[7i ❑ 2. Does the buyer have a homestead in Indiana to be ❑ Q 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
complete address of residence being vacated, property via e-mail? a pond ct eaformation
below.Pleases nstructiens for more informat(
' in udi ng county: _
17?,9g s 5R 16; Not avails a in all counties.)
Address(Numbers Street) 6-10-36-400-000. 609-021
a l S1/1 r/47 ey J�65 61 040/1 Jeremy R.Curl Dana url
ary,State ZIP Code County Primary property owner contact name E-mail