Homestead_Lopez H. PREPARER
Preparer of the Sales Disclosure Form Title
Payge Marx Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
James C. Bilderback
Addre. (number and eet) Address(number and street)
-�9rcvrc! L7�
City,sta Dao ZZIIPC t?,7, _ / �7°7(� City,state,and ZIP Code
Count /" Country
US
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.
s�ig4ature o eller - Signature of Seller
7.
I Print S Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Printed Name of Seller g
James C. Bilderback 11/10/2022
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIF. L T A LY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveya oc
Eric Lopez A�
Address(number and street) Address(number and street) NOI/I
7550 Hillside Road >3i 1022
City,state,and ZIP Code City,state,and ZIP CodeG, �a
eSON-oo �3r.
ej
Amarillo,TX 79119
Country r gUO '
Country U S ,T0
to appl for certain deductions.Identify all of those that apply:
YES NO CONDITION ES NO CONDITION
1.Will this property be the buyer's primary
O 0 3. Homestead
ClO residence? O 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated
0 O 5.Wind Power Device
�- 0 for this residence? If yes, provide address: 0 O 6.Hydroelectric Power Device
Address(number and street) O O 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county _Z—la
_/I'/di— 0.4 //95 Op?�
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
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i-Orer arl Watson Lana I itir , LLC,0 7412 Eagle Crest Blvd
Evansville, IN 47715