Homestead_Dyson;_
INDIANA SALES DISCLOSURE FORM
D.PREPARER
Diuluure Form
SDFID:
r��e
' 1122 E OHIO ST
Addrecs(NumberandSUee[)
E�mail
IAMES EDWARD DYSON
Sel/er2 - Name as appmrs on [onveynnre drcvmmt
Address (Number and Street)
F7 BRANGH IN 47670
Ciry, 5lote, and ZIP Code
Under penaltles of perjury, 1 hereby certify [ha[ [his Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance wi[h IC 6-11-5.5, "Real Property Sales Disclosure AcY.
,� 0.nrn.�n � n�.,.a�--
Signamreo(Seller ' � � � _ � ]nomreof5elier ' //_y
PROPERTY TA�£DUCTIONS- IDENTIFY ALL ITEI%S,THAT APPLY
Buyerl�Nameasappearsm
Ciry, Smu, andZlP Lode
TIIH SALFS DISCLOSURE FOM1 MAY BE USED TO APPLV FOR CERTAI\ DHDURIONS FOR
Q � 1. Will this proper[y be the 6uyer's primar
residence? Provide complete address of
residence, induding county:
Address (Number and Sveet) 1
� ��'": "�° a`� iiliQM.Ch Ulin`{b GIBSON
Ciry,SmuZIPCOde [ounry
� Q✓ 2. Does the buyer have a homestead in Indiana [o be
vacated for this residence? Ifyes, provide
comple[e address of residence being vacated,
induding county:
Addres (Number and SaxQ
Ciry. Smce ZIP Cade
Caunry
Buyer2 - Name os appears on
ond5uee[)
�✓ ❑ 3. Homes[ead
THATAPPLI'.
eatlng/Cooling Sys[em
S. Wind Power Device
6. Hydroelectric Power Device
❑ ❑✓ 7. Geo[hermal Energy Heabng/Cooling Device
� 0✓ 8. Is [his proper[y a residen[ial rental property?
� Q 9. Would you like [o receive tax statements for [his
property via e-mail? (Provide contoct informofion
6elow. Please see ins[ructions(or more information.
Not availa6le in all rounties.)
��- /o'-as� �os� an /e�3-�a�
Pnmarv nmoertv owner ronmtt name E-mail
Under penal[ies of perjury, 1 hereby certify tha[ this Sales Disclosure, [o the bes[ of my knowledge and belief, is [rue, correc[
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure AcY'. (No[e:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deductlon is
bein filed.]
�F'� n�1 in � A��
Sig. reo(Buyerl �
� i/
� PnncedLegalNameo(BUyerl SignDa¢(HM/D�/rvY1�
5ocia15ecuriry�Num6er
License/lD/Other Number
� /l2_� 1-( � �'„c/�'t�
SignamreofB�yer2/Spouse 3 /,� � ��D
I ANA WINKI FMAN-DYSON �9� ��1�
PdnredLegalNameo(Buyer2/Spovse SignDare(MM/�D/YYn7
� ��
LastSdigirso�Buyer2/SpouseDriver's Sm[e LastSDigiaa(SocialSecurity
Number License/ID/OtherNumber