Homestead_Conklin (5),q a�aorva-oa��8y/ .
1�'UTA�n SALES DISCI.OSUNE FOIt?1 SDF ID SUO IU 677979 Pa�,e 2
R PREPARGR
Samantha Cuisinqer
Rtpvn�o/the Scks Oarlosur. Form T�tle
226 W. Broadway Broadway Title. Inc.
AJJ�rn (Num4rr umf tiu.rQ Comyony
Prince�on, IN 47670. _
t�.�q��
Rex Steve Whitehouse
S:dlrr 1- Kunrr m npµvn urt mnve�nme Jm umem
7858 S 45 E
A�drrss (M�murr mW StreeQ
FL Branch, IN 47648-
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Donnabel Whitehouse
Srl4r: � Nume m npy.vn wunnnyvnae da urnenr
7858 S 45 E
AAQren (Number nnd S:rce[)
Ft. Branch,IN 4764&
Gry.Smre. nnA Z/P CWe
Under penalties o(perjury, 1 hereby certlfy that this Sales Disclosure, [o [he best of my knowledge and belie(, is true, correct
and complete as requir d by law, and is prepared in accordance with IC 6-1.L5.5, "Real Property Sales Disclosure Act".
Signnt�/rra(Srllrr � / Spn�S�rlf���'
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Kevin L Conklin
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,ICdrer (,YUmber unJSvert)
Ovrensville, �N 47665
Ci9t Smtr. and Z7PCMe
- APPLICATION FOR
cumeyvnreJxumen!
THE SALES DISCLOSURE FORN MAY BE USED TO APPLY FON CERTAIN DEDURIONS FOR
THAT APPLY
Cartie Mn Conklin /
Buyer2-NOmeucnppmnon �cynnceCacumme
Mdrvs (Numtie� anC StrerQ
Owensville, IN 47665
Ciry.Smce, ond ZIPCOde
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IDEM'IF1' ALL OF-TABSF�7'HAT APPLY.
x❑ � 1. Will this property be the buyer's primary
residence? Provide mmplete address of pri
residence, including rounty:
7858 5 45 E
AAdress (D'umMr anJ S�rree)
Ft. Branch, IN 47648 GIBSON
Ciry. Sm:eTIPCw'e Counry
X� � 2. Does [he bwer have a homestead in Indiana to be
vacated for this residence? If yes, provide
cumplete address of residence being vacated,
including county:
703 S. SMITH STREET
noAres� (tiumberoneS[rra[J
Owensville. IN a7665 GIBSON
Ory. Stntr LIY C�Je Counry
Q ❑ 3. Homestead
4. Solar Ener � F ' g/Cooling System
md Power Device
6. Hydroelectric Po�ver Device
❑ Q 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is this property a residential rental property?
❑ Q 9. �VOUId you like to receive tax statements for this
properry via e-ma il? (Provide conmct in%rmation
6elow. Please see rnstructions%r more in%rmation.
Not available in a(I rounties.)
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Under penalties otperjury, I hereby certify that this Sales Disclosure, m the best of my knowledge and belief, is true, correct
anA comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being fi1Qd.� /'Q �� � � n � � n ��
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