Homestead_Kathary H. PREPARER -mi
Preparer o` the Sales Disclosure Form Title
Sandra L. Hicks Attorney
Company
Address (number and street, city, state, country, and ZIP Code)843 S. 9th Avenue, Haubstadt, IN 47639
I. SELLERS)/GRANTOR(S)
•
Seller 1 - Name as it appears on conveyance document 1 Seller 2 - Name as appears on conveyance document
Thomas J. Davis Mary A. Davis
Address (number and street) Address (number and street)
210 Mary Street 210 Mary Street
City, State, and ZIP Code City, State, and ZIP Code
Albion, Illinois 62806 Albion, Illinois 62806
Country Country
' USA - Edwards County, IL USA - Edwards County, IL
Email Address {
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.
Signature f Seller Signature of Seller
,�,.� a
Prin ed ame of Seller Date Signed (mmldd/yyyy) Printed Name of4Seiler ` Date Signed mm/dd/
9 ( YYYY)
Thomas J. Davis 11 _� O� s Mary A. Davis , Z..L 15- 9
J. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDEN ALL THAT APPLY
B
Buyer 1 - Name as it appears on conveyance document ; Buyer 2 - Name as it appears on . . • e dcc t
Jonathon R. Kathary
Address (number and street) Address (number and street)
804 W. Evans Street --11:-)— ,
City, State, and ZIP Code --, City, State, and ZIP Code `' V
Princeton, IN 47670 2 0 2025
Country Country
USA - Gibson County, IN
Email Address
for certain deductions. Identify all of those t a ply:
YES NO CONDITION — - ---
YEES/ NO CONDITION
1. Will this property be the buyer'sprimaryLam' ❑ 3. Homestead
ii
❑ Y
residence?
0 [] 4. Solar Energy Heating or Cooling System
❑ d 2. Does the buyer have a homestead to be vacated 0 ❑ 5. Wind Power Device
for this residence? If yes, provide address: ❑ E] 6. Hydroelectric Power Device
Address (number and street) ❑ 0 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County g 12 2m ,..300 - col . [9-,
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