Homestead_Novak H. PREPARER
Preparer of the Sales Disclosure Form Title
Pamela Partenheimer Mick Attorney
Company
Address(number and street,city,state,country,and ZIP Code)
219 N. Hart St., P. O. Box 13, Princeton, IN 47670
I.SE1-Nam)/GRANTOR(S) F+E
Seller 1-Name as it appears on conveyance document Seller 2-Name as appe n n yan c en
Lewis Enterprises, LLC
Address(number and street) Address(number and street)
109 W. Locust Street AUG 0 3 2022 6,,City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 ltI_ ,
Country Country
Gibson USA GIBBON COUN TY AtiG 1��
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 pr•- rty,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Sig of Iler Signature of Seller
d'1 a'Printe a of eller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Peter J. Lewis, Managing Member 07/21/2022
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
Trey C. Novak Mekayla E. Novak
-
Address(number and street) Address(number and street)
720 College Ave Apt A 720 College Ave Apt A
City,state,and ZIP Code City,state,and ZIP Code
Vincennes, IN 47591 Vincennes, IN 47591
Country Country
Knox Knox
YES NO CONDITION YES NO CONDITION
Cl O 1.Will this property be the buyer's primary O 0 3.Homestead
residence? 0 O 4.Solar Energy Heating or Cooling System
O O 2.Does the buyer have a homestead to be vacated 0 CI 5.Wind Power Device
for this residence?If yes,provide address: O O 6.Hydroelectric Power Device
Address(number and street) 0 t 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
cQ6 —(Y— l3 -L oLt -oo 13y8 -_ n? r.
Under penalties of perjury,I hereby certify that 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 Level 5 felony.(Note:Both spouse's
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