HomeMy WebLinkAboutHomestead_Dorris H. PREPARER
Preparer of the Sales Disclosure Form Title
/�� n �t / Title Company�� -__ ._._.__._,__
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Address(number and street.city.state.country, and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
�ttt James Z.Wilson
Address(number and street) Address(number and street)
601 E Clark Street
City.state.and ZIP Code City.state,and ZIP Code
Owensville,IN 47665
Country Country
US
who knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifi s ny information required to be provided,commits a Level 5 felony.
• gna ure of Seller Signature of Seller
t
Pnn arne er Date signed(mrrx/ddryyyy) Printed Name of Seller I
igne m/dd/yyyy)
James Z.Wilson 09/23/2022 _ _ 0
J. BUYER(S)IGRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY A to
APPL -r
Buyer 2-Name as it appears on eyance doe 22
Buyer 1-Name as it appears on conveyance document Bu Y
Levi Jhay Donis
Address(number and street) Address(number and street) GSON COUQ�,j��
2307 Hicks Drive —
City,state.and ZIP Code City,slate,and ZIP Code UD/Tr
Evansville,IN 47714
Country Country
US
YES _NO CONDITION
1.Will this property be the buyer's primary
ID0 3. Homestead
a. residence? 0 fX 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated
0 a 5.Wind Power Device
0 for this residence?If yes.provide address: 0 (R 6. Hydroelectric Power Device
Address(number and street) ��- O C2 7.Geothermal Energy Heating or Cooling Device
City.slate.ZIP code,and county aL-k% -0-I-101 -00 0_ 22- --—0?_-2__ -
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
of 5 C C)PIY