Homestead_Vieke H. PREPARER
Preparer of the Sales Disclosure Form Title
J. Robert Kinkle Attorney
Company
Address(number and street,city,state,country,and ZIP Code)
219 N. Hart Street, Princeton,IN 47670
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Lewis Enterprises, LLC
Address(number and street) Address(number and street)
109 W. Locust Street
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648
Country Country
Gibson County, USA
knowingly and Intentionally falsifies the value of transferred
real p erty,or omits or falsifies any Information required to be provided,commits a Level 6 felony.
Si a ASfelt7 j Signature of Seller
Printed NauloSeller Date signed(mmldd/yyyy) Printed Name of Seller Date signed(mm/ddtyyyy)
Pete Lewis, Managing Member _ 12/14/2021
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Paul F. Vieke
Address(number and street) Address(number and street) .`4):,0:e..
208 W. Franklin Avenue
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 40FC
Country Country
Gibson County, USA ces �y
\ E-mail address Telephone number E-mail address Oho Telephoe0/ ber
( ) COGqq�,
(J Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to appC\Jly for certain deductions.Identify all oftfiI at apply:
t I YES NO CONDITION YES NO CONDITION 0�T
fl Q 1.Will this property be the buyer's primary
Q 3.Homestead O.Q
residence? 0 0 4.Solar Energy Heating or Cooling System
O 0 0 5.Wind Power Device
2.Does the buyer have a homestead to be vacated
for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device
Address number and sires 0 i21 7.Geothermal Energy Heating or Cooling Device
6. i t.- 5 County
stale,and---(Zi1,t ,.SAL L-Vie gg -- %- k? -13--Lott-o0( , -C�2b-
Under penalties of perjury,I hereby certify that this Sasclosure,to the best of my knowledge and belief,Is true,correct and complete
as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
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