Homestead_Rodriquez H. PREPARER
Preparer of the Sales Disclosure Form Title
Haley Smith Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLER(S)IGRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Julio Rodriguez White
Address(number and street) Address(number and street)
10( _4& Sr,RFs RR v o,tc- C
Cityr,I state,and ZIP Code City,state,and ZIP Code `Q
f j/co k-,k 1 Al el 7 G r?'i7 • t
Country Country
US US JU/
knowingly and inte fa4 Ifies the value of transfe
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. OCN
Signature o eller Signature of Seller Tj%q�
/lb
r nt of Sel, Date sine mm/ Printed Name of Seller Date signed(mm/dd/yyyy)
9 ( �YYYY1 � ( YYYY)
Julio Ro '.uez White O 9 Z��Z
J. BUYER S (GRANTEE S —APPLICATION FO PROP TY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Lindsey M. Rodriguez Keith Block
Address(number and street) Address(number and street)
2607 West Julie Drive 2607 West Julie Drive
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
YES NO CONDITION YES NO CONDITION
O 1.Will this property be the buyer's primary 0 O 3. Homestead
residence? O O 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated O 0 5.Wind Power Device
for this residence? If yes,provide address: O 0 6. Hydroelectric Power Device
Address(number and street) O 0 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 2/''—(1—1 c ,1 O) — 002
02 ' g LI .O