Homestead_Sisk (6) H. PREPARER
Preparer of the Sales Disclosure Form Title
Gwyn Shaw
Company
Address(number and street,city,state,country,and ZIP Code)
5231 Oak Grove Road,Suite A,Evansville,IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document
Gary W.Welch Seller 2-Name as appears on conveyance document t
Address(number and street)/�
hL / -7 i G C_�_2 ✓( ,• C) S Address(number and street)
City,state,and ZIP Code
C-X1..) .1 Ss,. t/"C< j) �l 7 6y c r City,state,and ZIP Code
Country Country
United States of America United States of America
person who knowingly and.intentionally fats value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Neks‘
Slgn�ti/re of Seller � r� .Signature of Seller
fPJri•`nted✓d Nameer `��9+.r- Date signed �'t 9�Dpte sig+ )
(mm/dd! ) Printed Name of Seller ��--
Gary W.Welch - i /- aZ. O
J.BUYER(S)IGRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDEOVICALL if; T
Buyer 1-Name as It appears on conveyance document Buyer 2-Name as appears on conveyance d'obu�f6iigt
• Emily Sisk Daniel Sisk 9G7 a
Address(number and street) Address(number and street) �T0,
6718W450S 6718W450S
City,state,and ZIP Code City,state,and ZIP Code
Owensville,IN 47665 Owensville,IN 47665
99 Country Country
���--11' United States of America United States of America
vEmail address mall address
f3d Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
9 YES NO CONDITION YES NO CONDITION
5 ,ri 0 1.Will this property be the buyer's primary residence? 0 3. Homestead
0 D Q 4. Solar Energy Heating or Cooling System
i
5 „�( ❑ 2.Does the buyer have a homestead to be vacated for ❑ CZ 5.Wind Power Device
C� �'l this residence?if yes,provide address: ❑ Q 6. Hydroelectric Power Device
1 1 Adddrrega,(nuber,ardsttrept) s ❑ ® 7.Geothermal Energy Heating or Cooling Device
4 C state,and ZIPCode � '�` C un
cv\cn,- -u�J1 1 N GO(FT �� c�� �� ' 3Ckoo- �03 .63 -C�21_
— Und •er penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, Is true,correct and complete
t 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
1.A
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