Homestead_Sailer (3) H, PREPARER
Preparer of the Sales Disclosure Form Tile
Kristina L.Watson Settlement Agent
Company
_ ......,. -_ —..
COmAany ... E-mail address
Bosse Title Company --.
Address(number and street.city.state.country,and ZIP Code)
4799 Rosebud Lane, Newburgh.IN 47630 .-----.
I.S£LLER(S)IGRANTOR(S) __.._. .__�-�1
Serer 1-Name as ii appears on conveyance document Seller 2-Name as appears on conveyatoms
Ova F.Salyer Ruth A.Salyer _ —
Address(number and street) Address(number and street) NOV 2 3 2022 C
-‘)
601 E.Oak St. 601 E.Oak St. v
G y.state,and ZIP Code City.state.and ZIP Code Fort Branch, IN 47648 Fort Branch,IN 47648 a. d�,&rrd)
�- Country GIBSON
C Country
US US •
—
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 C.F S'Ori�64 C pf L.-r ti
Printed
Nam--. -l1t�; �� Date U Y. �J 2_ G
Printed Name of Seiler signed(+nrr✓ddtyyYY} Printed Name of Seller 4 Date signed(mmlddJyyyy)
Ova F.Salyer `) - U Y ��-- Ruth A.Salyer 1 lid:?' cI
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
Rick Sailer Margaret Sailer
Address(number and street) Address(number end street)
_7719 Highway 66 7719 Highway 66
City,state.and ZIP Code
Clry,state,and ZIP Code
Wadesville,IN 47638 I Wadesville, IN 47638
.Country ' Country
.,,
YES NO CONDITION - YES NO CONDITION
1.Will this property be the buyer's primaryii( 0 3. Homestead
O residence? 0 ® 4. Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated id ?If address: O ( 5. Wind Power Device
T'\ for this resence yes,provide0 ( 6. Hydroelectric Power Device
Alls(,ruder a d street) �� Q ® 7.Geothermal Energy Heating or Cooling /Device
City,state, IF code,a d ooun _S�-O 2_ (c
-1�43� ���1�-� —1 �- off. 6 .
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
5
COPY