Homestead_Wise P ; "v•-•,7,;,
Preparer of the Sales Disclosure Form Title
Jill Gilillan Deed Specialist
Company E-mail address
Address(number and street,city,state,countty,and ZIP Code)
660 Woodward Avenue,Detroit, MI 48226
SP tO*41700 (s) F F. F I -4%
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Kevin R.Wise
Address(number and street) Address(number and street)
17 East Revere Boulevard,Apartment 102
City,state,and ZIP Code City,state,and ZIP Code FILED
Madison,AL 35756 Nov 1 6 2022
Country Country
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E-mail address Telephone number E-mail address 4"zeitetziTap
) GIBSON C RUNTY AU I g E
„requirqd,.13k.1.4W;*rid is prepared in-accordance with IC 6 1 1 5 Apersop who kfloWIflly and lntent(onally falsifies the value of transferred
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Signature of Seller Signature of Seller
Printed Name of Seller Date signed(mm/ddlyyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Kevin R.Wise
;..)•:;00E):449:dk.ANYBE(Vgi401i0IC;i4k41VO*Pii-dtiOiTif.
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Angela R.Wise
Address(number and street) Address(number and street)
5428 South State Road 165
City,state,and ZIP Code City,state,and ZIP Code
Owensville,IN 47665
Country Country
YES NO CONDITION YES NO CONDITION
r, 1.Will this property be the buyer's primary 0 3.Homestead
1)54 '—' residence? 0 4.Solar Energy Heating or Cooling System
al
0 2.Does the buyer have a homestead to be vacated 0 5.Wind Power Device
for this residence?If yes,provide address: 0IRI 6.Hydroelectric Power Device
Address(number and street) 0 El 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county oo 0O ci -
uxtcler penalties of perjur I hteby certify that thIs Sales Disctosure to the best of rry lnowIedge and belief is true,c0jrect and ompJete".,
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