Homestead_Mauck (5) H. PREPARER
Preparer of the Sales Disclosure Form Title
William H. Bender Attorney
Company
Address(number and street,city,state,country,and ZIP Code)
17 W. Main Street, Poseyville, IN 47633
I. SELLER(S)/GRANTOR(S) T
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on co abbe do m n
Estate of Darrell Vaughn Mauck `�
Address(number and street) Address(number and street) DfC
10243 W State Road 165 .P04224 cs
City,state,and ZIP Code City,state,and ZIP Codesy f'
Owensville,ille, IN 47665C Country G'es0A -
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 fal 'fies any Information required to be provided,commits a Level 5 felony.
Signature of Seller
Printed Na o ermm/dd�) rinted Name of Seller Date signed(mmldd/yyyy)
Estate of Darrell Vaughn Mauck
J. BUYER(S)IGRANTEE(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
Bill Kenneth Mauck
Address(number and street) Address(number and street)
10243 W State Road 165
City,state,and ZIP Code City,state,and ZIP Code
Owensville, IN 47665
Country Country
E-mail address
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary ✓I 0 3. Homestead
E residence? El El 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated El 0 5.Wind Power Device
for this residence?if yes, provide address: 6. Hydroelectric Power Device
Address(number and street) 0 El 7.Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code County
D•C - o0 1 . 1tc( -02--I
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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copy