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Homestead_Allen (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
-D,'PREPARER : -:1 . - - ..._ . _ .- . . . . .. - - -
Chris Sullivan Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
'
Larry D.York Kristy J.York
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
404SThirdSt 404SThirdSt
I
Address(Number and Street) Address(Number and Street)
Owensville,IN 47665 Owensville,IN 47665
state,and LIP Lode state,and LIP Code
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and corn lete 73e_quir by 1 nd is prepared in accordance with IC 6-1.1-5.5 "Real Property Sales Disclosure Act".
0 i2!6 74 c9 -D (/9/11 a — Dii.!(1
Signature off ler Sfgnatu/eofSell r
Larry D. ork Kristy J.York g f°1 2.0 ZD
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(AfM/DD/YYYYJ
`tF;:BUYER(S)/GRANTEEIS)- APPLICArWIONTORtPROPERITY`PAX DEDUCTIONS: .IDENTICY.ALL ITEMS THAT-APALY :- :,, -'F;
Jeffrey K.Allen
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
17860 1220 Rd 17860 1220 Rd
Address(Number and Street) Address(Number and Street)
Mt Carmel,IL 62863 Mt Carmel,IL 62863
Telephone Number FILED E-mail
THE SAL ISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERT .-IDENTIFY ALL OF THOSE THAT APPLY. Aug 11 2020
_YES NO CONDITION YES NO CONDITION OUULaStiliat
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary ❑ p 4.Solar Energy Heating/Cooling System
residence,including county: ❑ p 5.Wind Power Device
404 S Third St
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Owensville,IN 47665 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device
City,State Z!,P'Code County ❑ I[ t" 8.Is this property a residential rental property?
❑ [ 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?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) Jeffrey K.Allen 26-17-12-204-000. 008-022
City,State ZIP Code County Primary property owner contact name E-mail
.
Number License/ID/Other Number