Homestead_Hurley H. PREPARER
Preparer of the Sales Disclosure Form Title
Lindsay M. Phelps Searcher
Company
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway St,Princeton, IN, USA, 47670
I. SELLER(S)/GRANTOR(S) F LED
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on cony
Larry J. Kiesel Diane S. Kiesel
Address(number and street) Address(number and street) APR 2 0 2022
8694 S 450 W 8694 S 450 W .�!
City,state,and ZIP Code City,state,and ZIP Code y �,1,( �, .l�Yw.4aa)
Owensville, IN 47665 Owensville, IN 47665 GIBSON COUNTY AtJDlfiOts
Country Country
USA USA
E-mail address
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.
Signature of Seller n liiiioature of Seller
P`-d)` n
Q irir� ^(;✓/_ O.o t `}U .-AIL jC.
'-P Name of 9Ue Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Larry J. Ki619
el ,71 //. / /Z� Diane S. Kiesel 21- i,i_ '21-
J. BUYERS)/GRANTEE(S)-APPLICATION FOfi 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
Chance E. Hurley Amy D. Hurley
Al.`itrY(r 'rn {ansleV Road fnugl�ecdiqcsgt)Road
CfltaerRe7rdcodelN 47613 c yi ate dZIPcfodeIN 47613
Country Country
USA USA
E-mail address Telephone number
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary O 0 3. Homestead
residence? 0 O 4. Solar Energy Heating or Cooling System
O 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: 0 t 6.Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
1 Qa�`) Aiir tPt.��C'(
City,state,ZIP code,and county-r 1 lQ q c'
\1-N-er .e.� 1 tr\ ,_1-1tt'1.� ab^ ^ p O-too OO2-. l b QZ ---
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Page 3 of 5