Homestead_Adams (5)ILOSUREFORM SDFID:
Addr� (A'um 6er and SPeet)
Owensboro. KY 42301
liry, Smte, and ZIP Code
Seller 1- Nume as appears on ronveyance documen[
m'4TI3 m�is Drive �'Q�G� ���
Addre¢ (Numbe� andSVeeQ {r/�1n �/� ���/� �o � /,,
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Ciry,
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Prxessor
Title
Foreman Watson Land Tille. LLC
Company
E-ma//
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Sdfer2-Nameasappearsanronveyanredoaumm�t 7 -
,90dlrseveis�ive �� � / � �
Address(NumberondSo-eet) � � -
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Under penalties of perjury, l hereby certi that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple[e �< ro....:+rp:� b�y,law, a, epared in accordance wi[h IC 6d1-5.5, "Real Prop�r[y Sales Disclosure Ac[".
�
Bvyer I- Name as appvy/s an [anveyanre doavmen[
�
Nameas
Addrea (NUm 6er and Stree[J
PL Branch.IN 47648
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIfi DEDIIRIONS FOR THIS PROPERTY. IDEMIFY ALL OF TNOSE THAT APPLY.
�✓ � 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
Addrcs (NUmber an d Svee[)
Ciry, Smre ZIPCade [ounry
�✓ � 2. Does the buyer have a homes[ead in Indiana to be
vacated for [his residence? If yes, provide
complete address of residence being vacated,
intluding county:
702 North Walters
Addrea (Numberand SveerJ
Ft. Branch IN 47648 Gibson
dry.5rureZlPCode Counry
❑� ❑ 3. Homestead
� � 4. Solar Energy Hearing/Cooling System
� Q S. Wind Pawer Device
❑ ❑� 6. Hydroelectric Power Device
❑ Q 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is this property a residencial ren[al property?
� Q 9. Would you like to receive [a�c statements for this
proper[y via e-mail? (Provide ronmct in%rma[ion
beloiv. Please see instrucdons jor more information.
Not availa6le in all counties.J
�-/9-i�- �ai-aoi o�9- oa�
ownercanrncmame
Under penaltles of perjury, 1 hereby certify that [his Sales Disclosure, to the 6est of my knowledge and belief, is true, correc[
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 informa[ion, Social5eturity and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filedJ � _ ,��� ` ,✓1/� � n� � /
Sign Dale (MM/00/YYYYj
Pnn¢
Las[Sdigilso�Buyer]Driver's 5[afe Last50igifsafSocial5ecurityNum6er I LastSdigi[safBuyer2/SpauseDriver's Smte Las[SDigitro�5ocialSecurity
LicensepD/OrherNUmber Number License/ID/OtherNum6er