Homestead_Roland H. PREPARER
Preparer of the Sales Disclosure Form Title
Cathy Williams
Company
Address(number and street,city,state,country,and ZIP Code)
10510 E. 125 S. Oakland City, Indiana 47660
I. SELLERS)/GRANTOR(S) _ ,
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Lincoln Heights LLC.
Address(number and street) Address(number and street)
10510 E. 125 S.
City,State,and ZIP Code City,State,and ZIP Code
Oakland City, Indiana 47660
Country Country
Gibson pilephEmail
best of myknowledge and belief,i true,correc, • ' ete as
required by law,and is prepared in accordance with IC 6-1.1-5.5 A person who knowingly and intentionallW�al'pifi s the value • •nsferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 fe y. 4 0
ature of Seller Signatureof Seller
G463.80
4e �.�
Pri d Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller SON COV ./ate Signed(mm/dd/yyyy)
oio /P/C as. 42/ / /o /0 -225 Y4On/
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
Michael Roland Misty Roland
Address(number and street) Address(number and street)
330 West Dale Street 330 W. Dale Street
City,State,and ZIP Code City,State,and ZIP Code
Oakland City, Indiana 47660 Oakland City, Indiana 47660
Country Country
Gibson Gibson
Email 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 O OK 3. Homestead
2 0 residence? 0 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 O' 5.Wind Power Device
0 O for this residence? If yes,provide address' 0 (d Hydroelectric Power Device
Address(number and street) 0 U 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
a W - I - \8 - moo- c) c).L-►k--k -Q0-7.
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
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