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INDIAN,\ SAI,ES DISCLOSURE FORPi SDF ID SDO ID 468034 Veo� z
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605 5. E. Ma�in Luther Kinq Jr. BNd. Southwestem Indiana lanC Tltle
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�. � E: SELLER 5� /GRx1NTOR $'.... --... . _ ._..,^ _. .._..,::.,,....:.._ __ y� �...:;..._.. ._ ..., �.-.. � ..,._, .. .. . .. ., � .
�,`� Cijry Davis Cintly J. Davis
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7377 Buckeye Caun � t377 Buckeye Court
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Lavrrenceburg, IN a702S Lawrenceburg, IN 67025
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llnder penaldes of perjury. I hereby certif that this Sales Disdosure, to lhe 6est of my knowledge and belief, is Irue, correct
and�omplete as requir d by law �y is epared� ip accordance wi[h IC 64.1-5.5, "Real PropeiYy Sales Disclosure Act".
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� o/ � Uc�s -s ' b b Cindy J. Davis y Fmily Smith, AIF 4/29/1
F. BUYER S�GRANTEE S-APALICATION FOR PROPERTY�TAX DEDUCTfONS- IDE�TIFY ALL ITEMSTHA7 Af?PLY
Tony J. DYbn
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40183 5. CuaA Cwssing Dme� �
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HauEStadt, IN 47634
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TNE SALES DISCLOSUNE FORM MAY BE USED TO APPLY' FOR CEPTAIA DEDURIONS FOR THIS PROPERTV. IUENTIFI' ALL OF THOSE THAT APVIY.
YES NO CONOITIOV YES NO CONUITION
Q � 3. tVitl this property be the buyer's primary Q ❑ 3. Homescead
residence? Provide comple[e addi ess of primary � � 4. Solar Gnergy Heating/Coo)ing System
residence, incfuding county: � Q 5. Wind Power Device
10183 S. OVAIL CROSSING DRIVE
Addrm(flumberovdS+rcclf ❑ Q 6. Hydroelecu'(c Power Device
Hauostadt, iN a7639 GiBSON � � 7. Geo[hcrmal Energy Heacing/Coofing Device
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��] 2. Does the buyer havc a homestead in Indiana co 6e � 0 8� Is thls properry a residential rental properry?
vacated for this residence? f(}•es, provide ❑ � 9. Would you like to receive taz stacemen� for this
complete address o( residence being vacated, I property via e-mail? (Provide cw�tact in%rmotion
induding caunty: befow. Please see instructrons%r more in/ormatiorr.
h'ot avarlabfe in alf counties.)
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Under penalties of periury, 1 hereby certify that [his Sales Disclosure, to the best of my knowledge and belief, is trve, correct
and complete as required by law, and is prepared in accordanre wfth IC 6-1.15.5,'Real Property Sales �ISdosure At['. (Note:
Spause Informatlon, Social Security and Driver's License/Other num6ers are not necessary if no Hamestead Deduction is
being filed.)
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Tony J. Dillon by Emily Smith, AIF 5/5/10
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