Homestead_Wood (15) H. PREPARER
Prep(ier f the Sales los re Form Title
vInfi_` eill Settlement Agent
Company -
Address(number and street,city.state,country,and ZIP Code)
20 NW 1st Street,Suite 100,Evansville, IN 47708
I. SELLER(S)IGRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on
Johnnie Ray Dallas Conner re=
Address(number and street) Address(number and street) -
1432 Olympic Ct IC Lai)) ('J' vtJ;(-Ca - (iMns✓:iie fit// ?)
City.slate.and ZIP Code City,state,and ZIP Code N U V 1 3 Z02
Evansville,IN 47715
Country Country e. h,../zL�t e a. . / Q./
USAUniTrIP
/,/ y�/
E-mail address (
commits a Level 5 felony.
Signatu Seller Signature of Seller
Printed Name of Seller Date signed(mmfdd/yyyy) Printed Name of Seller Date signed(mm/ddlyyyy)
Johnnie Ray Dallas Conner 11/15/2022 11/15/2022
J. BUYER(S)IGRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Alexander C.Woods
Address(number and street) Address(number and street)
1216 McKinley St
City.state,and ZIP Code City,state,and ZIP Code
Princeton,IN 47670
Country Country
YES NO CONDITION
0 S.Will this property be the buyer's primary i 0 3.Homestead
residence? 0 (2 4. Solar Energy Heating or Cooling System
12(2.Does the buyer have a homestead to be vacated 0 GI 5.Wind Power Device
for this residence?If yes.provide address: 0 ( 6.Hydroelectric Power Device
Address(number and street) 0 (2 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
o00-\) - �$ ' 002 - os-' — 0 2B
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Last 5 Digits of Buyer 2/Spouse SSN/Driver s License/ID/Other Number
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