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Homestead_Saliju (2)
H. PREPARER Preparer of the Sales Disclosure Form Title Amy B,Pollard Settlement Agent Company Address(number and street,oily,stale.country,and ZiP Code) -- 7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715 I. SELLER(S)IGRANTOR(S) 1 • Seller 1—Name as it appears on conveyance document . Sollor 2 Name as appears on conveyance document, _ GAW Properties,LLC Address(number and street) Address(number and street) PO Box 1077 City,state.and ZIP Code — CO,stale,and;ZlP Code —�-- --- Princeton,IN 47670 j Country _—___.__.. __ Cournry _ �T ,� _ _.__._.____ 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. Sig cure Of eller:---' ) /� S'-••alure of Seller �� y` • f! •�l/�{/� ,� , 1'l.,. `r� - /tom r I IV b Printed Name of 5 Dal't•ned(mm./ddryyyy) Printed Name• 'i ile Date signed( mldd/yyyy) Anita J.Waldroup,Member _ 031D �1� � ,`7/2023 -_ � 03/07/2023 J. BUYER(S)IGRANTEE(S)-APPLICATION FOR PROPERTY TAX DLz'DUCTIONS-IDEN ALL THAT APPLY Buyer 1 --Name as it appears on conveyance document Buyer 2—Namo as it appears on conveyance document Alit Saliju , Florent Saliju i _ Address(number end street) Address(numlier and street) 915 Chickasaw Dr 915 Chlckasavr Dr City,slate,and ZIP Code City.slate,and ZIP Coda Fort Branch,IN 47648 ` T—� ---- --- Fort Branch,IN 47648 Country Country .....__ �_ —0 1.Will this property be the buyer's primary VI 0 i 3. Homestead residence? © (q ! 4,Solar Energy Healing or Cooling System 0 (2.Does the buyer have a homeslead to be vacated 0 1 5.Wind Power Device for this residence?if yes,provide address: 0 Q 6.Hydroelectric Power Device Address(number and street) 0 17.Geothermal Energy Heating or Cooling Device City,stale,ZIP code,and county q(_kG_`I — Z^O — DO1-3/9 _OZ C 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 ,