Homestead_Cross H. PREPARER Title
Preparer of the Sales Disclosure Form Closing Agent
Candace Rogers
Columbia Title, Inc
Address(number and street,city,state,country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
ears on conveyance document Seller 2-.Name as appears on conveyance document
Seller 1 -Name as it app Jayci N. Bilby
Aaron T. Bilby
Address(number and street)
Cl Address(number and street) C., C ��
1`sta ,3C�C*k v e �J�t City,state,and ZIP Code
ty,state,and ZIP Cade `k , `
' L `j Country
Cou — USA
USA Telephone number
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,come mits of a Level 5 felony.
Signature of Seller
3 Printed Name of Seller Date signed(mm/dd/yyyy)
ler
Printed Name of Seller Date signed(mm/dd/yyyy) I$/4/2022
8/4/2022 Jayci N. Bilby
Aaron T. Bilby
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTYTAX DEDaUCeTIIONSas itp-pears IDEoNTIFYnconv ALL THAT
APPLY
Buyer 1-Name as it appears on conveyance document y
er 2-NShel R. Cross d street) pit
Address(number and street) .
2282 Old State Road 65 City,state,and ZIP Code -16-7
City,state,and ZIP 6 AUG
Owensville, IN 47665 Country ay�j Q zo22
Country ^
NO CONDITION
p 0 3.Homestead
1.Will this property be the buyer's primary O O residence? 0
04.Solar Energy Heating or Cooling System
0 p 5.Wind Power Device
X.
O this
the buyer If yea rovidehomestead to bes: vacated 0 C) 6.Hydroelectric Power Device
for this residence? If yes,provide address:
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 26-11- -1 t O oo. g1'l� - Z
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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