Homestead_Wallis (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Path Kolb Closing Manager
Company
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway St., Princeton, IN 47670
I. SEI-Nam)/GRANTOR(S) F T t d T
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conve n e c e t 1■J)
Kevin L. Kling Amy C. Kling
Address(number and street) Address(number and street) MAY 17 2022
2720 E SR 64 2720 E SR 64
City,state,and ZIP Code City,state,and ZIP Code a -
Princeton, IN 47670 Princeton, IN 47670 /2Gce-+uttE a. yr ..)
Country Country
GIB50N COUNTY AUDtTOPt
USA USA
E-mail address
)
Under penalties of perjury,I hereby certify this Sales Disclosure,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 evel 5 felony.
Signat of Sell Signature ofAl:r /
Printe a�eller Date signed(mm/dd/yyyy) Printed Name .f S- -r / Date signed(mm/dd/yyyy)
Kevin L. Kling 5�;zfzazz Amy C. Kline J 511a boa a
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
Jerry R.Wallis Nikki Jo Wallis
Address(number and street) Address(number and street)
500 S Willard St. 500 S Willard St.
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648
Country Country
USA USA
E-mail address
- 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:
YES NO CONDITION YES NO CONDITION
O 1.Will this property be the buyer's primary O 0 3.Homestead
CO residence? O O 4.Solar Energy Heating or Cooling System
O O C)2. Does the buyer have a homestead to be vacated
0 O 5.Wind Power Device
for this residence? If yes, provide address: O 6. Hydroelectric Power Device
i Address(number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
(-5 500 S Willard St.
r City,state,ZIP code,and county qq
SE,: Fort Branch, IN 47648 aL-\Z- I ) - '1OO -00 I .I\3 -OZ -
c- Under 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
'4E5 transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
C '
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